Healthcare Provider Details

I. General information

NPI: 1689214942
Provider Name (Legal Business Name): JORGE ENRIQUE SANCHEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1477 AVENIDA ASHFORD APT 1408
SAN JUAN PR
00907-6103
US

IV. Provider business mailing address

PO BOX 79813
CAROLINA PR
00984-9813
US

V. Phone/Fax

Practice location:
  • Phone: 585-622-7609
  • Fax:
Mailing address:
  • Phone: 585-622-7609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number22659
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: