Provider Demographics
NPI:1366485054
Name:SANCHEZ, LUIS A (MD)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:A
Last Name:SANCHEZ
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 1:229 RD 2 APT 11E
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-0143
Mailing Address - Country:US
Mailing Address - Phone:787-781-2853
Mailing Address - Fax:787-781-2853
Practice Address - Street 1:229 RD 2 APT 11E
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-0143
Practice Address - Country:US
Practice Address - Phone:787-781-2853
Practice Address - Fax:787-781-2853
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2868174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2868OtherSTATE LICENSE
PRC77207Medicare UPIN