MEDICARE: DR. LIVETTE MILAN-SEPULVEDA 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	207V00000X	Obstetrics & Gynecology Physician	12261	PR

General Provider Information

NPI Number	:	1396828943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LIVETTE MILAN-SEPULVEDA M.D.

Provider Business Mailing Address
First Line	:	409 CALLE REINA ISABEL
Second Line	:	LA VILLA DE TORRIMAR
City	:	GUAYNABO
State	:	PR
Zip	:	00969-3342
Country	:	US
Telephone Number	:	787-294-0113
Fax Number	:	787-751-4417

Provider Business Practice Location Address
First Line	:	TORRE AUXILIO MUTUO, SUITE 614
Second Line	:	735 PONCE DE LEON AVE.
City	:	SAN JUAN
State	:	PR
Zip	:	00919-1227
Country	:	US
Telephone Number	:	787-294-0113
Fax Number	:	787-751-4417

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/08/2007

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