Organization
SPACE COAST PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARLEENE SEPULVEDA MD (PEDIATRICIAN)
(772) 269-1904
Entity
Organization
Contact information
Practice address
8045 SPYGLASS HILL RD STE 105, VIERA, FL 32940-8567
(321) 467-1660
Mailing address
8045 SPYGLASS HILL RD STE 105, VIERA, FL 32940-8567
(772) 269-1904
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770813552
NPI
FL
Enumeration date
06/05/2024
Last updated
10/25/2024
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