Healthcare Provider Details

I. General information

NPI: 1023362357
Provider Name (Legal Business Name): SANCHEZ DERMATOPATHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2012
Last Update Date: 11/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516B CALLE JUAN J JIMENEZ
SAN JUAN PR
00918-2605
US

IV. Provider business mailing address

516B CALLE JUAN J JIMENEZ
SAN JUAN PR
00918-2605
US

V. Phone/Fax

Practice location:
  • Phone: 787-751-6018
  • Fax:
Mailing address:
  • Phone: 787-751-6018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JORGE L SANCHEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-751-6018