Provider Demographics
NPI:1003891656
Name:SANCHEZ, JUAN CARLOS (MD)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:CARLOS
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7707 N UNIVERSITY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2954
Mailing Address - Country:US
Mailing Address - Phone:954-840-2233
Mailing Address - Fax:954-840-4100
Practice Address - Street 1:7707 N UNIVERSITY DR STE 101
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2954
Practice Address - Country:US
Practice Address - Phone:954-840-4068
Practice Address - Fax:954-840-2236
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME883002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268087401Medicaid
81463ZOtherMEDICARE
FL81463Medicare PIN