Provider Demographics
NPI:1619192184
Name:SEPULVEDA ACOSTA, JULIO NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:NELSON
Last Name:SEPULVEDA ACOSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIO
Other - Middle Name:NELSON
Other - Last Name:SEPULVEDA ACOSTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:H3 CALLE H
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1742
Mailing Address - Country:US
Mailing Address - Phone:787-313-5093
Mailing Address - Fax:
Practice Address - Street 1:650 CALLE LLOVERAS
Practice Address - Street 2:COND CENTRO PLAZA SUITE 104
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-625-1446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR017223207UN0902X, 2085D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy