Provider Demographics
NPI:1699929885
Name:PADILLO, ULYSSES E (PT)
Entity type:Individual
Prefix:MR
First Name:ULYSSES
Middle Name:E
Last Name:PADILLO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 MICCOSUKEE COMMONS DR
Mailing Address - Street 2:STE 3
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-6400
Mailing Address - Country:US
Mailing Address - Phone:850-656-3163
Mailing Address - Fax:850-656-3463
Practice Address - Street 1:1818 MICCOSUKEE COMMONS DR
Practice Address - Street 2:STE 3
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-6400
Practice Address - Country:US
Practice Address - Phone:850-656-3163
Practice Address - Fax:850-656-3463
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 24408225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist