Provider Demographics
NPI:1518072503
Name:SANCHEZ, JOSE ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10051 5TH STREET NORTH #200
Mailing Address - Street 2:JSA HEALTHCARE ATTN TINA FASETTI
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-2211
Mailing Address - Country:US
Mailing Address - Phone:727-828-2370
Mailing Address - Fax:727-568-6011
Practice Address - Street 1:2835 WEST DELEON STREET
Practice Address - Street 2:JSA HYDE PARK PRIMARY CARE CENTER
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609
Practice Address - Country:US
Practice Address - Phone:813-251-0194
Practice Address - Fax:813-254-0279
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2010-12-22
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Provider Licenses
StateLicense IDTaxonomies
FLME23223207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064160000Medicaid
FL064160000Medicaid
FL11326Medicare PIN