Basic Information
| Provider Information | |||||||||
| NPI: | 1245698497 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PADILLA RODRIGUEZ | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | CHRISTINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PMB #79 PO BOX 70344 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874202700 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | SAN JUAN CITY HOSPITAL | ||||||||
| Address2: | CENTRO MEDICO | ||||||||
| City: | SAN JUAN, PUERTO RICO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874802700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2016 | ||||||||
| LastUpdateDate: | 08/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 21398 | PR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | 21398 | PR | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 21398 | PR | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 208D00000X | 14032 | PR | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.