Individual
DR. LILLIAN GONZALES SEPULVEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
701 W COCOA BEACH CSWY, COCOA BEACH, FL 32931-3585
(321) 868-5871
(321) 868-5852
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1982
(321) 868-5852
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
ME130526
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021657600
—
FL
01
—
JB251Z
FL MEDICARE
FL
Enumeration date
05/20/2014
Last updated
03/19/2020
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