Provider Demographics
NPI:1346874138
Name:SANCHEZ, LISSETTE K (CSA)
Entity Type:Individual
Prefix:
First Name:LISSETTE
Middle Name:K
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 E OAKLAND PARK BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1148
Mailing Address - Country:US
Mailing Address - Phone:954-791-6146
Mailing Address - Fax:954-337-2733
Practice Address - Street 1:1995 E OAKLAND PARK BLVD STE 350
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1148
Practice Address - Country:US
Practice Address - Phone:954-791-6146
Practice Address - Fax:954-337-2733
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant