Provider Demographics
NPI:1043586563
Name:SANCHEZ-LONGO, LUIS F (MS)
Entity Type:Individual
Prefix:PROF
First Name:LUIS
Middle Name:F
Last Name:SANCHEZ-LONGO
Suffix:
Gender:M
Credentials:MS
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 190309
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-0309
Mailing Address - Country:US
Mailing Address - Phone:787-244-7244
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL DEL MAESTRO
Practice Address - Street 2:505 SERGIO CUEVAS, PRIMER NIVEL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-244-7244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1931103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist