Healthcare Provider Details

I. General information

NPI: 1851446835
Provider Name (Legal Business Name): JOSE E SANCHEZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 AVE ESMERALDA PONCE DE LEON
GUAYNABO PR
00969-4429
US

IV. Provider business mailing address

PO BOX 2037
GUAYNABO PR
00970-2037
US

V. Phone/Fax

Practice location:
  • Phone: 787-720-3101
  • Fax: 787-272-6750
Mailing address:
  • Phone: 787-761-1625
  • Fax: 787-272-6750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number636
License Number StatePR

VIII. Authorized Official

Name: MR. JOSE E SANCHEZ
Title or Position: OWNER
Credential: MT
Phone: 787-720-3101