Provider Demographics
NPI:1316499627
Name:PADRON, VANESSA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:
Last Name:PADRON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 NW 18TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1009
Mailing Address - Country:US
Mailing Address - Phone:786-623-8364
Mailing Address - Fax:
Practice Address - Street 1:3521 NW 18TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1009
Practice Address - Country:US
Practice Address - Phone:786-623-8364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9330292163W00000X
FLARNP 9330292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 9330292OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
FLF0916185OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION PROGRAM