Individual
ERNESTO SEPULVEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
33 CALLE VICTORIA, ANASCO, PR 00610-2932
(787) 826-6540
(787) 826-6520
Mailing address
PO BOX 628, MAYAGUEZ, PR 00681-0628
(787) 834-5809
(787) 826-6520
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
160
PR
Other
Enumeration date
10/26/2005
Last updated
09/16/2010
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