Provider Demographics
NPI:1043532369
Name:SANCHEZ CHAVEZ, JOSE JESUS (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:JESUS
Last Name:SANCHEZ CHAVEZ
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 1:1841 SW 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-1607
Mailing Address - Country:US
Mailing Address - Phone:305-804-9326
Mailing Address - Fax:888-602-9306
Practice Address - Street 1:4011 W FLAGLER ST
Practice Address - Street 2:204
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1643
Practice Address - Country:US
Practice Address - Phone:305-774-1234
Practice Address - Fax:305-774-1639
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115049207Q00000X, 2084N0400X, 2084V0102X, 207R00000X
CO50986207R00000X, 2084N0400X, 2084V0102X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology