=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073930426
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAMARYS SANCHEZ MFS, PSY.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2014
-----------------------------------------------------
Last Update Date | 03/24/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4601 PONCE DE LEON BLVD STE 280
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33146-2110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-668-5301
-----------------------------------------------------
Fax | 305-938-5004
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4601 PONCE DE LEON BLVD STE 280
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33146-2110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-668-5301
-----------------------------------------------------
Fax | 305-938-5004
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | PY7505
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------