Healthcare Provider Details

I. General information

NPI: 1043593510
Provider Name (Legal Business Name): MARTHA ROSA SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 W 49TH PL STE 210
HIALEAH FL
33012-3187
US

IV. Provider business mailing address

1315 W 80TH ST
HIALEAH FL
33014-3451
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-4008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCNA 40906
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: