Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 683 | PR |
NPI | 1003119355 |
---|---|
Provider Name | Dr. Karen Montalvo-Sepulveda |
First Address | Mayaguez, PR 00680-1860 |
Second Address | Aguadilla, PR 00603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2010 |
Last Update Date | 22/05/2018 |