Provider Demographics
NPI:1447238407
Name:SANCHEZ-TORRES, MODESTO (MD)
Entity Type:Individual
Prefix:DR
First Name:MODESTO
Middle Name:
Last Name:SANCHEZ-TORRES
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:PO BOX 550436
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33355-0436
Mailing Address - Country:US
Mailing Address - Phone:954-915-0199
Mailing Address - Fax:
Practice Address - Street 1:19051 COLLINS AVE
Practice Address - Street 2:UNIT D114
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-2346
Practice Address - Country:US
Practice Address - Phone:954-915-0199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL674032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269287200Medicaid
FL41577EMedicare ID - Type Unspecified
G50627Medicare UPIN