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Myrtle Ridge Primary Care, P.A

General Practice Physician in Lutz, FL · enumerated 2020 · authorized official Yudaisy Mogena Padron, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1619504354

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Registry record

Entity type Organization (Type 2)
Legal business name Myrtle Ridge Primary Care, P.A
Other name <Unavail>
Practice address 1539 Dale Mabry Hwy Ste 102, Lutz, FL, 33548
Phone (813) 909-7102
Fax (813) 909-0199
Enumeration date Mar 24, 2020
Last updated in NPPES Jan 8, 2026

Taxonomy & classification

101YM0800X Mental Health Counselor Behavioral Health & Social Service Providers Secondary
103T00000X Psychologist Behavioral Health & Social Service Providers Secondary
208D00000X General Practice Physician Allopathic & Osteopathic Physicians Primary
363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Yudaisy Mogena Padron
Title Owner
Phone (813) 909-7102

Other identifiers

Identifier Type State Issuer
10D1050075 Other FL CLIA
129484600 Medicaid FL -
129485400 Medicaid FL -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Myrtle Ridge Primary Care, P.A?
The NPI for Myrtle Ridge Primary Care, P.A is 1619504354, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Myrtle Ridge Primary Care, P.A?
NPPES lists Yudaisy Mogena Padron (Owner) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-01-08.