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General NPI Number Information
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NPI Number | 1578966651
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Entity Type | Individual
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Provider Name | IDELIS SANCHEZ PHARM D
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Gender | Female
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | STREET #3 KM 82 PLAZA HUMACAO BO. JUNQUITO
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-285-0001
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Fax | 787-285-0099
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Provider Business Mailing Address
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Address Line | 60 CAMINO DE LOS FLAMBOYANES
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City | GURABO
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State | PR
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Zip | 00778-9677
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Country | US
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Telephone | 787-543-8681
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Fax | 787-285-0099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5363
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License Number State | PR
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