Provider Demographics
NPI:1174639652
Name:SANCHEZ, PEDRO PABLO (CRT47185)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:PABLO
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:CRT47185
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5765 SW 8 ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144
Mailing Address - Country:US
Mailing Address - Phone:305-260-4635
Mailing Address - Fax:305-260-4636
Practice Address - Street 1:5765 SW 8 ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144
Practice Address - Country:US
Practice Address - Phone:305-260-4635
Practice Address - Fax:305-260-4636
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4038335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
W9940Medicare ID - Type Unspecified