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General NPI Number Information
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NPI Number | 1801974548
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Entity Type | Organization
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Legal Business Name | SANCHEZ DE FUENTES AND REAL MD PA
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1170 CYPRESS GLEN CIRCLE HUNTER'S CREEK PROFESSIONAL PARK
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City | KISSIMMEE
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State | FL
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Zip | 34741-4998
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Country | US
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Telephone | 407-847-6166
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Fax | 407-847-5112
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Provider Business Mailing Address
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Address Line | 1170 CYPRESS GLEN CIR HUNTER'S CREEK PROFESSIONAL PARK
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City | KISSIMMEE
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State | FL
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Zip | 34741-7560
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Country | US
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Telephone | 407-847-6166
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Fax | 407-847-5112
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD A REAL
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Credential | M.D.
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Telephone | 407-847-6166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0063371
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License Number State | FL
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