Provider Demographics
NPI:1447419528
Name:JUAN SANCHEZ MD PA
Entity Type:Organization
Organization Name:JUAN SANCHEZ MD PA
Other - Org Name:AMERICAN EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF
Authorized Official - Prefix:MISS
Authorized Official - First Name:RHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANDOC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-847-1111
Mailing Address - Street 1:5340 GULF DR
Mailing Address - Street 2:SUITE101
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-3950
Mailing Address - Country:US
Mailing Address - Phone:727-847-1111
Mailing Address - Fax:727-849-3937
Practice Address - Street 1:5340 GULF DR
Practice Address - Street 2:SUITE101
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-3950
Practice Address - Country:US
Practice Address - Phone:727-847-1111
Practice Address - Fax:727-849-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0020960207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062440301Medicaid
FL180007901OtherMEDICARE RAILROAD
FL062440300Medicaid
FL180021476OtherMEDICARE RAILROAD
FL51066Medicare PIN
FL062440301Medicaid
FL0499550001Medicare NSC
FL180021476OtherMEDICARE RAILROAD