=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639473515
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARNALDO SANCHEZ D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2011
-----------------------------------------------------
Last Update Date | 02/02/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1502 E FOWLER AVE APT 2812
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33612-5416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-866-0950
-----------------------------------------------------
Fax | 813-866-0929
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 82969
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33682-2969
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-866-0930
-----------------------------------------------------
Fax | 813-866-0929
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | DO1156
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | OS10984
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------