MEDICARE: MISS KARLA VANESSA PADILLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1801199351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KARLA VANESSA PADILLA

Provider Business Mailing Address
First Line	:	11469 NW 93RD CT
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4268
Country	:	US
Telephone Number	:	786-609-4578
Fax Number	:

Provider Business Practice Location Address
First Line	:	11469 NW 93RD CT
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4268
Country	:	US
Telephone Number	:	786-609-4578
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2010
Last Update Date	:	08/05/2021

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