Provider Demographics
NPI:1972709749
Name:SEDA OLMO, NORBERT J (MD)
Entity Type:Individual
Prefix:
First Name:NORBERT
Middle Name:J
Last Name:SEDA OLMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SABANERA DEL RIO CAMINO LOS FRUTALES
Mailing Address - Street 2:# 4
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-5229
Mailing Address - Country:US
Mailing Address - Phone:787-673-6229
Mailing Address - Fax:787-687-4606
Practice Address - Street 1:POINT LAGOON ESTATES A-10
Practice Address - Street 2:APT 1012
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-983-5074
Practice Address - Fax:787-680-0803
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15062208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice