MEDICARE: ANA SEDA CORDERO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	11458	PR

General Provider Information

NPI Number	:	1952388597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA SEDA CORDERO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 8221
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00732-8221
Country	:	US
Telephone Number	:	787-847-3778
Fax Number	:	787-847-1305

Provider Business Practice Location Address
First Line	:	149 ROAD KM 58.0
Second Line	:	SECTOR TIERRA SANTA
City	:	VILLALBA
State	:	PR
Zip	:	00766-2228
Country	:	US
Telephone Number	:	787-847-3778
Fax Number	:	787-847-1305

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/24/2005
Last Update Date	:	02/08/2011

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