Individual
MACKENZIE AILEEN MIRANDA PADILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1799 SALK AVE, TAVARES, FL 32778-4311
(352) 742-8300
Mailing address
1799 SALK AVE, TAVARES, FL 32778-4311
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11041035
FL
Other
Enumeration date
09/23/2025
Last updated
03/10/2026
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