Healthcare Provider Details

I. General information

NPI: 1093644619
Provider Name (Legal Business Name): LEONARDO MANCHA SANCHEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 W 49TH PL
HIALEAH FL
33012-3197
US

IV. Provider business mailing address

1475 W 49TH PL
HIALEAH FL
33012-3113
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7761
  • Fax:
Mailing address:
  • Phone: 305-284-7761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTRN44886
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: