F Sepulveda Physiatry & Sports Medicine

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

18434 Issued in PR

Legal business name

F SEPULVEDA PHYSIATRY & SPORTS MEDICINE

Practice address

100 Carr 165 Torre 1 Suite 303
Guaynabo, PR 00968-8049

Phone

(787) 277-0847

NPI assigned

Oct 30, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fernando Luis Sepulveda-Irizarry, MDNPI 1720396518

Title

Sole Owner

Phone

(787) 378-9667

Specialties & licenses 1

Addresses

Other names 1

• F SEPULVEDA PHYSIATRY & SPORTS MEDICINE, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fernando Luis Sepulveda-Irizarry, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Guaynabo, PR
  • NPI 1720396518

  Sports Medicine

  Medicare reassignment NPD Authorized official
• Brenda Luz Rivera Fuentes, MD

  • General Practice Physician
  • Guaynabo, PR
  • NPI 1083350623
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676505600000",
    "number": "1841742459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CALLE DEL MUELLE APT 2301",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009012669",
            "telephone_number": "787-378-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CARR 165 TORRE 1 SUITE 303",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009688049",
            "telephone_number": "787-277-0847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "576 Ave Arterial B",
            "address_2": "Coliseum Tower Apt 1906",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009182200",
            "country_code": "US",
            "telephone_number": "787-957-5553",
            "fax_number": "787-957-5710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 ES-12 AVENIDA FRAGOSO",
            "address_2": "VILLA FONTANA",
            "address_purpose": "LOCATION",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00983",
            "country_code": "US",
            "telephone_number": "787-276-7006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Carr 696",
            "address_purpose": "LOCATION",
            "city": "Dorado",
            "state": "PR",
            "postal_code": "006465718",
            "country_code": "US",
            "telephone_number": "787-625-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "F SEPULVEDA PHYSIATRY & SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-30",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "SEPULVEDA-IRIZARRY",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "787-378-9667",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PR",
            "license": "18434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "F SEPULVEDA PHYSIATRY & SPORTS MEDICINE, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "F SEPULVEDA PHYSIATRY & SPORTS MEDICINE, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.