Healthcare Provider Details

I. General information

NPI: 1326588351
Provider Name (Legal Business Name): JORGE SANCHEZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2017
Last Update Date: 02/23/2017
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

DALI B 10 QUINTAS DE SAN LUIS
CAGUAS PUERTO RICO
00725
UM

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number76803
License Number StatePR

VIII. Authorized Official

Name: MR. JORGE A SANCHEZ II
Title or Position: NURSE
Credential: BSN
Phone: 787-599-3501