Provider Demographics
NPI:1386749596
Name:PADRON, SEBASTIAN A (MD)
Entity type:Individual
Prefix:DR
First Name:SEBASTIAN
Middle Name:A
Last Name:PADRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2057
Mailing Address - Country:US
Mailing Address - Phone:305-443-5031
Mailing Address - Fax:305-442-0844
Practice Address - Street 1:4141 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2057
Practice Address - Country:US
Practice Address - Phone:305-443-5031
Practice Address - Fax:305-442-0844
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43021208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053398000Medicaid
FL053398000Medicaid