MEDICARE: DR. IDA S SANCHEZ-PICA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	3214	PR

General Provider Information

NPI Number	:	1063402576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IDA S SANCHEZ-PICA MD

Provider Business Mailing Address
First Line	:	2501 N STEVENS ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22311-1510
Country	:	US
Telephone Number	:	703-671-1147
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 FARRELL RD
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-5901
Country	:	US
Telephone Number	:	703-805-0536
Fax Number	:	703-805-0512

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	01/25/2026

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