Individual provider Active NPI

Willma L Padro, M.D.

  • General Practice Physician
  • Orlando, FL
National Provider Identifier
1184935900
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16962 Issued in PR
Practice address
1130 S Semoran Blvd
Ste. B
Orlando, FL 32807-1457
Phone
(650) 279-9703
NPI assigned
Jun 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN 345 FL
General Practice Physician 208D00000X 16962 PR Primary

Addresses

Primary practice location

1130 S Semoran Blvd
Ste. B
Orlando, FL 32807-1457

Mailing address

6675 Westwood Blvd
Ste 475
Orlando, FL 32821-6027
Phone (407) 845-0330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210413000299 FL Practitioner - General Practice 1557779592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Home Alliance, LLCGroup PAC ID 6406096536, 60 clinicians

Practice addresses (Care Compare)

684 State Rd 60
Lake Wales, FL 33853-4419
Phone (863) 949-4668

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN 345FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Home Alliance LLC CurrentSince Aug 15, 2021 Accepting new patients
Medical Home Alliance LLC CurrentSince Apr 1, 2021 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients

Locations

684 State Road 60 W
Lake Wales, FL 33853
Phone (863) 949-4668

6675 Westwood Blvd
Ste 475
Orlando, FL 32821
Phone (407) 845-0384

199 Avenue K SE
Winter Haven, FL 33880
Phone (563) 588-1424

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1184935900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 WESTWOOD BLVD",
            "address_2": "STE 475",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216027",
            "telephone_number": "407-845-0330",
            "fax_number": "888-972-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 S SEMORAN BLVD",
            "address_2": "STE. B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328071457",
            "telephone_number": "650-279-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADRO",
        "first_name": "WILLMA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN 345",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.