Provider Demographics
NPI:1154089456
Name:SANCHEZ RIVERA, EDDIE R
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:R
Last Name:SANCHEZ RIVERA
Suffix:
Gender:M
Credentials:
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 277
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-0277
Mailing Address - Country:US
Mailing Address - Phone:787-381-9663
Mailing Address - Fax:787-735-6584
Practice Address - Street 1:CALLE JULIO CINTRON 202
Practice Address - Street 2:EDIFICIO GUAYACAN 106-B
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-0277
Practice Address - Country:US
Practice Address - Phone:787-381-9663
Practice Address - Fax:787-735-6584
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR62175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7873819663Other7873819663