Provider Demographics
NPI:1194695940
Name:RODRIGUEZ SEPULVEDA, MIGUEL ENRIQUE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ENRIQUE
Last Name:RODRIGUEZ SEPULVEDA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 5499
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-9678
Mailing Address - Country:US
Mailing Address - Phone:939-248-7871
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA PR-3 KM 123.0
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723
Practice Address - Country:US
Practice Address - Phone:787-839-5015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist