Healthcare Provider Details

I. General information

NPI: 1295704633
Provider Name (Legal Business Name): LIANA SANCHEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 AVENUE C NW
WINTER HAVEN FL
33881-4527
US

IV. Provider business mailing address

635 1ST ST N
WINTER HAVEN FL
33881-4129
US

V. Phone/Fax

Practice location:
  • Phone: 863-294-0670
  • Fax: 863-298-3200
Mailing address:
  • Phone: 863-294-0670
  • Fax: 863-298-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME94712
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: