Healthcare Provider Details

I. General information

NPI: 1457762957
Provider Name (Legal Business Name): PATRICIA SANCHEZ P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9804 SW 40TH ST
MIAMI FL
33165-3912
US

IV. Provider business mailing address

9804 SW 40TH ST
MIAMI FL
33165-3912
US

V. Phone/Fax

Practice location:
  • Phone: 305-222-9154
  • Fax: 305-222-9155
Mailing address:
  • Phone: 305-222-9154
  • Fax: 305-222-9155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9107435
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: