Provider Demographics
NPI:1043299043
Name:ODIOTT-SANCHEZ, FELIX MIGUEL (MD)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:MIGUEL
Last Name:ODIOTT-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:PO BOX 224
Mailing Address - Street 2:URB SAN ANTONIO EH 2
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0224
Mailing Address - Country:US
Mailing Address - Phone:787-826-2538
Mailing Address - Fax:
Practice Address - Street 1:CALLE 65 INFANTERIA
Practice Address - Street 2:#37
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-605-0730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12245208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
G45362Medicare UPIN