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Individual

DR. ROSAN MARIE SEQUEDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
712 53RD AVE E, BRADENTON, FL 34203-5827
(941) 755-2456
(877) 788-3881
Mailing address
1302 RIVER ST, PALATKA, FL 32177-5042
(386) 326-7342
(386) 325-1086

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
17923
PR
208D00000X
General Practice Physician
Primary
ACN910
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DS199A
PTAN
PR
Enumeration date
05/26/2010
Last updated
05/19/2021
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