Provider Demographics
NPI:1609948215
Name:BADILLO, PEDRO (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:
Last Name:BADILLO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 COND. TURQUESA CALLE 535
Mailing Address - Street 2:APT T-17 BUZON 404
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-3131
Mailing Address - Country:US
Mailing Address - Phone:787-276-8716
Mailing Address - Fax:
Practice Address - Street 1:SANTURCE MEDICAL MALL
Practice Address - Street 2:PONCE DE LEON PARADA 26
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-728-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4862208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC - 77322Medicare UPIN