Provider Demographics
NPI:1881980423
Name:SEPULVEDA, CECILY ANN (RPH)
Entity type:Individual
Prefix:MS
First Name:CECILY
Middle Name:ANN
Last Name:SEPULVEDA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE WINSTON CHURCHILL, ESQ. PARANA EL SENORIAL
Mailing Address - Street 2:
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00925
Mailing Address - Country:US
Mailing Address - Phone:787-751-7219
Mailing Address - Fax:787-751-7250
Practice Address - Street 1:AVE WINSTON CHURCHILL, ESQ. PARANA EL SENORIAL
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00925
Practice Address - Country:US
Practice Address - Phone:787-751-7219
Practice Address - Fax:787-751-7250
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist