Basic Information
| Provider Information | |||||||||
| NPI: | 1265863864 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SEBASTIAN A PADRON MD,PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4131 SW 6TH ST | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331342057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054421740 | ||||||||
| FaxNumber: | 3054422207 | ||||||||
| Practice Location | |||||||||
| Address1: | 4305 E 8TH AVE | ||||||||
| Address2: | SUITE E | ||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330132465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057695601 | ||||||||
| FaxNumber: | 3057690473 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2013 | ||||||||
| LastUpdateDate: | 12/17/2013 | ||||||||
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| AuthorizedOfficialLastName: | PADRON | ||||||||
| AuthorizedOfficialFirstName: | SEBASTIAN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3054422228 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | ME43021 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.