Provider Demographics
NPI:1447960117
Name:PADILLA, LYNNETTE M (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:M
Last Name:PADILLA
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8614 SW 147TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1503
Mailing Address - Country:US
Mailing Address - Phone:305-741-9956
Mailing Address - Fax:
Practice Address - Street 1:8614 SW 147 PL
Practice Address - Street 2:MIAMI, FL 33193
Practice Address - City:MIAMI, FLORIDA, UNITED STATES
Practice Address - State:FL
Practice Address - Zip Code:33193-1503
Practice Address - Country:US
Practice Address - Phone:305-741-9956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26110922246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26110922OtherPRIVATE INSURANCE
26110922OtherPRIVATE INSURANCE