Provider Demographics
NPI:1770813552
Name:SEPULVEDA, ARLEENE MICHELLE (MT, ASCP, MD)
Entity type:Individual
Prefix:DR
First Name:ARLEENE
Middle Name:MICHELLE
Last Name:SEPULVEDA
Suffix:
Gender:F
Credentials:MT, ASCP, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13832 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3296
Mailing Address - Country:US
Mailing Address - Phone:787-410-0893
Mailing Address - Fax:
Practice Address - Street 1:13832 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3296
Practice Address - Country:US
Practice Address - Phone:787-410-0893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27756R208D00000X
FLME146420208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice