Provider Demographics
NPI:1023342409
Name:PADILLA CEDO, ANTONIO C (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:C
Last Name:PADILLA CEDO
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 1:1 CALLE 11 APT 1609
Mailing Address - Street 2:PANORAMA PLAZA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6051
Mailing Address - Country:US
Mailing Address - Phone:787-942-8191
Mailing Address - Fax:
Practice Address - Street 1:1 CALLE 11 APT 1609
Practice Address - Street 2:PANORAMA PLAZA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6051
Practice Address - Country:US
Practice Address - Phone:787-942-8191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17765208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice