Provider Demographics
NPI:1902808678
Name:BADILLO, PEDRO FRANCISCO (MD)
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:FRANCISCO
Last Name:BADILLO
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 1:801 MEADOWS RD
Mailing Address - Street 2:STE 105
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2346
Mailing Address - Country:US
Mailing Address - Phone:561-392-2021
Mailing Address - Fax:561-394-4175
Practice Address - Street 1:801 MEADOWS RD
Practice Address - Street 2:STE 105
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2346
Practice Address - Country:US
Practice Address - Phone:561-392-2021
Practice Address - Fax:561-394-4175
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56665207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
060025661OtherRAILROAD MEDICARE
FL062154400Medicaid
060025661OtherRAILROAD MEDICARE
FL09720YMedicare PIN