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NPI Code Detail

MEDICARE: MR. SEBASTIAN SAMUEL LEON LAUSELL MEDICAL STUDENT

MEDICARE:  MR. SEBASTIAN SAMUEL LEON LAUSELL  MEDICAL STUDENT
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1518449099
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SEBASTIAN SAMUEL LEON LAUSELL MEDICAL STUDENT
Provider Business Mailing Address
First Line : 165 AVE HOSTOS APT 639
Second Line :
City : SAN JUAN
State : PR
Zip : 00918-4244
Country : US
Telephone Number : 787-423-9223
Fax Number :
Provider Business Practice Location Address
First Line : 165 AVE HOSTOS APT 639
Second Line :
City : SAN JUAN
State : PR
Zip : 00918-4244
Country : US
Telephone Number : 787-423-9223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2018
Last Update Date : 08/31/2018

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Directions to “ MR. SEBASTIAN SAMUEL LEON LAUSELL MEDICAL STUDENT” Practice Location

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