Healthcare Provider Details

I. General information

NPI: 1487905790
Provider Name (Legal Business Name): MRS. GRETCHEN G SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2012
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BELLA VISTA COMMERCIAL CTR # 1 SUITE 1A
BAYAMON PR
00957-6051
US

IV. Provider business mailing address

1 BELLA VISTA COMMERCIAL CTR # 1 SUITE 1A
BAYAMON PR
00957-6051
US

V. Phone/Fax

Practice location:
  • Phone: 787-797-2709
  • Fax: 787-730-2255
Mailing address:
  • Phone: 787-797-2709
  • Fax: 787-730-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number8942
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: