Provider Demographics
NPI:1447764212
Name:SANCHEZ, STEVENS J
Entity Type:Individual
Prefix:
First Name:STEVENS
Middle Name:J
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9674 NW 10TH AVE LOT F603
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-1558
Mailing Address - Country:US
Mailing Address - Phone:786-234-9301
Mailing Address - Fax:
Practice Address - Street 1:9674 NW 10TH AVE LOT F603
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-1558
Practice Address - Country:US
Practice Address - Phone:786-234-9301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program