Healthcare Provider Details

I. General information

NPI: 1073085361
Provider Name (Legal Business Name): CARLOS A SANCHEZ RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2018
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14476 SW 13TH TER
MIAMI FL
33184-3537
US

IV. Provider business mailing address

14476 SW 13TH TER
MIAMI FL
33184-3537
US

V. Phone/Fax

Practice location:
  • Phone: 786-901-0448
  • Fax:
Mailing address:
  • Phone: 786-901-0448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11047662
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: