Individual provider Active NPI

Sandra Elizabeth Flamenco de Padilla, LCSW, ACHP-SW

  • Clinical Social Worker
  • Seminole, FL
National Provider Identifier
1609495894
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW16196 Issued in FL
Practice address
8139 Coachlight Cir
Seminole, FL 33776-3510
Phone
(954) 560-2737
NPI assigned
Apr 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW16196 FL Primary

Addresses

Primary practice location

8139 Coachlight Cir
Seminole, FL 33776-3510

Mailing address

8139 Coachlight Cir
Seminole, FL 33776-3510
Phone (954) 560-2737

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200730000535 FL Practitioner - Clinical Social Worker 8123443769 Reassigns benefits to 1 organization
Practice locations: Seminole, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Seminole, FL 33776
Phone (954) 560-2737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW16196FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Mercy Sunday Clinical CurrentSince Apr 16, 2020 Accepting new patients
MCR Health, Inc. CurrentSince Aug 29, 2020 Accepting new patients
MCR Health, Inc. CurrentSince Aug 29, 2020 Accepting new patients
Eddy Supplies CurrentSince Jun 10, 2024 Accepting new patients

Locations

725 N 12th Ave
#B
Arcadia, FL 34266
Phone (863) 494-1242

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1609495894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8139 COACHLIGHT CIR",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337763510",
            "telephone_number": "954-560-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8139 COACHLIGHT CIR",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337763510",
            "telephone_number": "954-560-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAMENCO DE PADILLA",
        "first_name": "SANDRA",
        "middle_name": "ELIZABETH",
        "credential": "LCSW, ACHP-SW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-08",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

Verify at the official NPI Registry.