Provider Demographics
NPI:1366334872
Name:PINHEIRO LIMA PADILLA, IVAN
Entity type:Individual
Prefix:
First Name:IVAN
Middle Name:
Last Name:PINHEIRO LIMA PADILLA
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 1:110 W 39TH ST APT 1701
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-3144
Mailing Address - Country:US
Mailing Address - Phone:443-764-1541
Mailing Address - Fax:
Practice Address - Street 1:1609 BELLONA AVE
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5528
Practice Address - Country:US
Practice Address - Phone:410-887-7778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2456888146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic