Provider Demographics
NPI:1609978089
Name:PADRON, ALBERTO FRANCISCO (MD)
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:FRANCISCO
Last Name:PADRON
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 1:1814 LUCERNE TER
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2949
Mailing Address - Country:US
Mailing Address - Phone:407-730-3627
Mailing Address - Fax:407-423-3817
Practice Address - Street 1:1814 LUCERNE TER
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2949
Practice Address - Country:US
Practice Address - Phone:407-730-3627
Practice Address - Fax:407-423-3817
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0075038208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51732OtherBLUE CROSS BLUE SHIELD
FL100399000Medicaid
FL263208000Medicaid
FL51732OtherBLUE CROSS BLUE SHIELD
FLBK754XMedicare PIN
FLBK754YMedicare PIN
FLBK754ZMedicare PIN