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General NPI Number Information
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NPI Number | 1003342494
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Entity Type | Individual
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Provider Name | LUIS RUBEN SEPULVEDA GARCIA
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Gender | Male
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | RYDER MEMORIAL HOSPITAL #355 CALLE FONT MARTELO
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-852-0768
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Fax |
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Provider Business Mailing Address
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Address Line | PALMARES DE MONTEVERDE 94 RAMAL 842 APT 55
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-674-9500
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Fax | 803-721-8003
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 22687
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 22687
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License Number State | PR
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