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General NPI Number Information
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NPI Number | 1457468043
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Entity Type | Individual
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Provider Name | LOURDES V SEPULVEDA PADILLA M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 8133 CALLE CONCORDIA SUITE 202
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City | PONCE
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State | PR
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Zip | 00717-1543
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Country | US
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Telephone | 787-843-1700
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Fax | 787-842-0900
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Provider Business Mailing Address
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Address Line | PO BOX 335038
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City | PONCE
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State | PR
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Zip | 00733-5038
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Country | US
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Telephone | 787-843-1700
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Fax | 787-842-0900
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 13345
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13345
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License Number State | PR
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