Provider Demographics
NPI:1407367352
Name:SANCHEZ, GUSTAVO A (RBT)
Entity Type:Individual
Prefix:
First Name:GUSTAVO
Middle Name:A
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4485 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1958
Mailing Address - Country:US
Mailing Address - Phone:347-456-5320
Mailing Address - Fax:
Practice Address - Street 1:4485 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1958
Practice Address - Country:US
Practice Address - Phone:347-456-5320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician