Provider Demographics
NPI:1699982959
Name:PADILLA, EVELINE H (MD)
Entity type:Individual
Prefix:DR
First Name:EVELINE
Middle Name:H
Last Name:PADILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:275 GALEON CT
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6529
Mailing Address - Country:US
Mailing Address - Phone:305-662-5860
Mailing Address - Fax:305-662-5817
Practice Address - Street 1:4410 W 16TH AVE
Practice Address - Street 2:SUITE #61
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7100
Practice Address - Country:US
Practice Address - Phone:305-364-2888
Practice Address - Fax:305-364-2883
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME55351207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME55351OtherLICENSE