Healthcare Provider Details
I. General information
NPI: 1023487147
Provider Name (Legal Business Name): ROBERTO E SANCHEZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2015
Last Update Date: 04/02/2022
Certification Date: 04/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1695 NW 110TH AVE STE 218
SWEETWATER FL
33172-1929
US
IV. Provider business mailing address
PO BOX 942575
MIAMI FL
33194-2575
US
V. Phone/Fax
- Phone: 305-456-7580
- Fax: 786-536-5689
- Phone: 305-456-7580
- Fax: 786-536-5689
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERTO
ENRIQUE
SANCHEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 786-525-8567