Provider Demographics
NPI:1962386474
Name:PADILLA MALDONADO, BREDWIN JOEL
Entity type:Individual
Prefix:
First Name:BREDWIN
Middle Name:JOEL
Last Name:PADILLA MALDONADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 CALLE MONTE BLANCO
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-5737
Mailing Address - Country:US
Mailing Address - Phone:787-380-5181
Mailing Address - Fax:
Practice Address - Street 1:608 CALLE MONTE BLANCO
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5737
Practice Address - Country:US
Practice Address - Phone:787-380-5181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical