1932179157 NPI number — SOFIA PADILLA MD

Table of content: SOFIA PADILLA MD (NPI 1932179157)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932179157 NPI number — SOFIA PADILLA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PADILLA
Provider First Name:
SOFIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PADILLA-BAFALLUY
Provider Other First Name:
SOFIA
Provider Other Middle Name:
AESCHLIMAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932179157
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6450
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-6450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-805-1818
Provider Business Mailing Address Fax Number:
787-832-1585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL BELLA VISTA
Provider Second Line Business Practice Location Address:
CARR 349 KM 2.7 CERRO LAS MESAS
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-834-6000
Provider Business Practice Location Address Fax Number:
787-832-1585
Provider Enumeration Date:
01/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  4779 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 067029 . This is a "LA CRUZ AZUL DE PR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 95913 . This is a "SSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6605753523 . This is a "MEDICAL CARD SYSTEMS HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2458B . This is a "PREFERRED MEDICARE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0095913 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6605753523 . This is a "MCS CLASSIC CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 601075 . This is a "MEDICARE MUCHO MAS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 95913 . This is a "MEDICARE OPTIMA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6605753523 . This is a "MEDICAL CARD SYSTEMS INC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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