Healthcare Provider Details

I. General information

NPI: 1992812440
Provider Name (Legal Business Name): JULIO B SEGURA OJEDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8024 CALLE CONCORDIA OFI.301 EDIF MORALES
PONCE PR
00717
US

IV. Provider business mailing address

P O BOX 33908
PONCE PR
00733-0908
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-2439
  • Fax: 787-840-2439
Mailing address:
  • Phone: 787-840-2439
  • Fax: 787-840-2439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6933
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: