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Individual
MRS. YUDAISY MOGENA PADRON
Active
Individual
MRS. YUDAISY MOGENA PADRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
0105383
FL
363A00000X
Physician Assistant
2295PA
PR
363A00000X
Physician Assistant
Primary
PACN68
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116404300
—
FL
01
—
2295PA
PUERTO RICO MEDICAL DISCIPLINE AND LICENSUREE BOARD
PR
01
—
CBHCM0105383
FLORIDA CERTIFICATION BOARD
FL
01
—
CBHCMS0102580
FLORIDA CERTIFICATION BOARD
FL
01
—
PACN68
PHYSICIAN ASSISTANT
FL
Enumeration date
12/07/2022
Last updated
07/16/2025
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