Healthcare Provider Details

I. General information

NPI: 1043532773
Provider Name (Legal Business Name): MARIA SEPULVEDA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13475 SOUTHERN BLVD STE 100
LOXAHATCHEE FL
33470-9233
US

IV. Provider business mailing address

13475 SOUTHERN BLVD STE 100
LOXAHATCHEE FL
33470-9233
US

V. Phone/Fax

Practice location:
  • Phone: 561-793-1713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9243685
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9243685
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: