Basic Information
| Provider Information | |||||||||
| NPI: | 1760108617 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PADRON | ||||||||
| FirstName: | ROLANDO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20900 BISCAYNE BLVD | ||||||||
| Address2: | |||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801495 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056827000 | ||||||||
| FaxNumber: | 3056827031 | ||||||||
| Practice Location | |||||||||
| Address1: | 20900 BISCAYNE BLVD | ||||||||
| Address2: | |||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801495 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056827000 | ||||||||
| FaxNumber: | 3056827031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2022 | ||||||||
| LastUpdateDate: | 10/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 11022376 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.