Provider Demographics
NPI:1295729101
Name:PADILLA-BRUNO, MARIA A (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:PADILLA-BRUNO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ALICIA
Other - Last Name:PADILLA-BRUNO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:SANTA CRUZ STREET #73
Mailing Address - Street 2:SANTA CRUZ MEDICAL BUILDING, SUITE 214
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6911
Mailing Address - Country:US
Mailing Address - Phone:787-798-5899
Mailing Address - Fax:787-787-9905
Practice Address - Street 1:SANTA CRUZ STREET #73
Practice Address - Street 2:SANTA CRUZ MEDICAL BUILDING, SUITE 214
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6911
Practice Address - Country:US
Practice Address - Phone:787-798-5899
Practice Address - Fax:787-787-9905
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4803207N00000X, 207NI0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0026830Medicare Oscar/Certification
PA26830PAMedicare ID - Type Unspecified
D99517Medicare UPIN