Provider Demographics
NPI:1962601633
Name:PADILLA-RODRIGUEZ, KATHERINE MARIE (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIE
Last Name:PADILLA-RODRIGUEZ
Suffix:
Gender:F
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:DA-3 CALLE HASTINGS
Mailing Address - Street 2:GARDEN HILLS NORTE
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2128
Mailing Address - Country:US
Mailing Address - Phone:787-653-5060
Mailing Address - Fax:787-653-9880
Practice Address - Street 1:30 CALLE PADIAL STE 120
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3842
Practice Address - Country:US
Practice Address - Phone:787-653-5060
Practice Address - Fax:787-653-9880
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17,9072084N0400X
PR179072084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology