Provider Demographics
NPI:1306974712
Name:PADILLA, MARIA EUGENIA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:EUGENIA
Last Name:PADILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STREET 3 D-19 HILLSIDE
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6665
Mailing Address - Country:US
Mailing Address - Phone:787-789-9216
Mailing Address - Fax:
Practice Address - Street 1:STREET 3 D-19 HILLSIDE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6665
Practice Address - Country:US
Practice Address - Phone:787-789-9216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16490208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics