Healthcare Provider Details

I. General information

NPI: 1285169409
Provider Name (Legal Business Name): JORGE SANCHEZ RN BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 04/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B10 CALLE DALI QUINTAS DE SAN LUIS
CAGUAS PR
00725-7602
US

IV. Provider business mailing address

B10 CALLE DALI QUINTAS DE SAN LUIS
CAGUAS PR
00725-7602
US

V. Phone/Fax

Practice location:
  • Phone: 787-599-3501
  • Fax:
Mailing address:
  • Phone: 787-599-3501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number76803G
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: