MR. VICTOR CECILIO PADRON (NPI# 1801317805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801317805 |
| Entity Type | Individual |
| Full Name | MR. VICTOR CECILIO PADRON |
| Credential | PA |
| Practice Address |
103 Medicine Way Road Peridot AZ 85542 |
| Mailing Address |
16845 Nw 78th Ave Miami Lakes FL 33016-8439 |
| Practice Telephone | 9284751400 |
| Mailing Telephone | 3053001212 |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2017-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
6720 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
103 MEDICINE WAY ROAD |
| City | PERIDOT |
| State | AZ |
| Zip Code | 85542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922068808 | Analise Kathryn Lucas | Physician Assistant | 103 Medicine Way Road, Peridot, AZ 85542 | 2006-03-24 |
| 1891260816 | Joy Martin | Nurse Practitioner | 103 Medicine Way Road, Peridot, AZ 85542 | 2018-10-05 |
| 1114407913 | Brian Cluff | Pharmacist | 103 Medicine Way Road, Peridot, AZ 85542 | 2018-08-21 |
| 1528557485 | Jessica M Madrid | Nurse Practitioner | 103 Medicine Way Road, Peridot, AZ 85542 | 2018-05-07 |
| 1710475124 | San Carlos Apache Healthcare Corporation | Durable Medical Equipment & Medical Supplies | 103 Medicine Way Road, Peridot, AZ 85542 | 2018-05-01 |
| 1790209492 | Heidi Sieglinde Lucas | Registered Nurse | 103 Medicine Way Road, Peridot, AZ 85542 | 2017-08-03 |
| 1790232288 | Rachel Ann Shorthouse | Dietitian, Registered | 103 Medicine Way Road, San Carlos Apache Healthcare Corp, Peridot, AZ 85542 | 2016-09-01 |
| 1992154694 | San Carlos Apache Healthcare Corporation | Emergency Medicine | 103 Medicine Way Road, Peridot, AZ 85542 | 2016-06-03 |
| 1356790059 | San Carlos Apache Healthcare Corporation | Dentist | 103 Medicine Way Road, Peridot, AZ 85542 | 2016-06-03 |
| 1619326311 | San Carlos Apache Healthcare Corporation | Occupational Therapist | 103 Medicine Way Road, Peridot, AZ 85542 | 2016-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768963 | Layla Rose Wall | Dietitian, Registered | 103 Medicine Road, Peridot, AZ 85542 | 2019-12-26 |
| 1912555830 | Megan M Dillon | Registered Nurse | 102 Medicine Way Rd, Phn Building, Peridot, AZ 85542 | 2019-09-04 |
| 1538638184 | Christopher Blair | Pharmacist | 103 Medicine Way Drive, Peridot, AZ 85542 | 2018-11-13 |
| 1346772548 | Dyanna Ah Quin | Social Worker | 106 Medicine Way, Peridot, AZ 85542 | 2017-03-28 |
| 1548610223 | Acey Nixon | Dentist | 104 Medicine Way, Peridot, AZ 85542 | 2016-06-14 |
| 1952756793 | Fern Dewey | Dental Hygienist | 103 Medicine Way, Peridot, AZ 85542 | 2016-04-29 |
| 1649496829 | Dorothea Blanche Stevens | Registered Nurse | 102 Medicine Way, Peridot, AZ 85542 | 2007-04-17 |
| 1508916933 | Paul Brandon Mcmaster | Podiatrist | San Carlos Apache Healthcare, 103 Medicine Way, Peridot, AZ 85542 | 2007-01-10 |
| 1487756656 | Renal Dimensions, LLC | Clinic/Center | Us 70 Highway Srt 170, Peridot, AZ 85542 | 2006-09-01 |
| 1356810907 | Pamela N Tambi | Pharmacist | 103 Medicine Way, Peridot, AZ 85542 | 2018-11-13 |
| Find all providers in zip 85542 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928374 | Michael James Porter | Physician Assistant | 20003 N 77th Dr, Glendale, AZ 85308-8339 | 2020-09-30 |
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1194343897 | Alyssa Kay Poland | Physician Assistant | 10006 W Los Gatos Dr, Peoria, AZ 85383-3343 | 2020-07-08 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1932748233 | Hayley Klotz | Physician Assistant | 440 N Navajo Dr, Page, AZ 86040-0950 | 2020-01-03 |
| 1285273987 | Jaclyn Marie Schroeder | Physician Assistant | 7649 E Pinnacle Peak Rd Ste 100, Scottsdale, AZ 85255-6296 | 2019-12-27 |
| 1396388062 | Morgan Taylor Beckwith | Physician Assistant | 2128 Senita Dr, Lake Havasu City, AZ 86403-5756 | 2019-10-24 |
| 1023667623 | Halie Furrier | Physician Assistant | 5345 E Gleneagles Dr, Tucson, AZ 85718-1803 | 2019-09-05 |
| 1871155143 | Terry Craven Wood | Physician Assistant | 7645 W Donald Dr, Peoria, AZ 85383-3142 | 2019-07-08 |
| 1720548753 | Alexis D Elliott | Physician Assistant | 2350 Miracle Mile # 600a, Bullhead City, AZ 86442-7505 | 2019-03-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.