Organization
PADRE PIO CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANA RODRIGUEZ NP (MEDICAL DIRECTOR)
(414) 520-3896
Entity
Organization
Contact information
Practice address
3700 E WILLIAMS FIELD RD APT 2040, GILBERT, AZ 85295-7000
(414) 520-3896
Mailing address
3700 E WILLIAMS FIELD RD APT 2040, GILBERT, AZ 85295-7000
(414) 520-3896
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
43966-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34152600
—
WI
Enumeration date
10/19/2012
Last updated
09/29/2022
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