MEDICARE: DIANA CONSTANZA SANCHEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA16984	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972954105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA CONSTANZA SANCHEZ

Provider Business Mailing Address
First Line	:	5580 LAKEWOOD CIR S
Second Line	:	HOUSE E
City	:	MARGATE
State	:	FL
Zip	:	33063-5256
Country	:	US
Telephone Number	:	954-993-1647
Fax Number	:

Provider Business Practice Location Address
First Line	:	5979 NW 151ST ST STE 208
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-2446
Country	:	US
Telephone Number	:	954-303-9335
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2016
Last Update Date	:	03/20/2019

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Directions to “ DIANA CONSTANZA SANCHEZ ” Practice Location

Language	Start Address	Practice Location

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