Provider Demographics
NPI:1003130592
Name:SANCHEZ, STEPHANIE R (ACNP-BC,FNP-BC, ARNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:R
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:ACNP-BC,FNP-BC, ARNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:AREIZAGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:595 W GRANADA BLVD
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5190
Mailing Address - Country:US
Mailing Address - Phone:407-415-3871
Mailing Address - Fax:
Practice Address - Street 1:545 W GRANADA BLVD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5103
Practice Address - Country:US
Practice Address - Phone:386-672-6243
Practice Address - Fax:386-677-7463
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3278052363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDC660ZMedicare Oscar/Certification