Healthcare Provider Details

I. General information

NPI: 1265027429
Provider Name (Legal Business Name): MR. KENNETH E SANCHEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7726 WINEGARD RD FL 2
ORLANDO FL
32809-7147
US

IV. Provider business mailing address

4621 YELLOW BAY DR
KISSIMMEE FL
34758-2508
US

V. Phone/Fax

Practice location:
  • Phone: 407-961-8585
  • Fax:
Mailing address:
  • Phone: 407-961-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: