Provider Demographics
NPI:1952388597
Name:SEDA CORDERO, ANA (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:SEDA CORDERO
Suffix:
Gender:F
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:PO BOX 8221
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-8221
Mailing Address - Country:US
Mailing Address - Phone:787-847-3778
Mailing Address - Fax:787-847-1305
Practice Address - Street 1:149 ROAD KM 58.0
Practice Address - Street 2:SECTOR TIERRA SANTA
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-2228
Practice Address - Country:US
Practice Address - Phone:787-847-3778
Practice Address - Fax:787-847-1305
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-24
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11458207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG40943Medicare UPIN
PR0084238Medicare ID - Type Unspecified