Healthcare Provider Details

I. General information

NPI: 1669240990
Provider Name (Legal Business Name): DR. LYNETTE SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 02/06/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 111 INT 602 KM 1.8 BARRIO ANGELES
UTUADO PR
00641
US

IV. Provider business mailing address

PO BOX 1696
UTUADO PR
00641-1696
US

V. Phone/Fax

Practice location:
  • Phone: 787-628-2650
  • Fax:
Mailing address:
  • Phone: 787-628-2650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number23613
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: