Provider Demographics
NPI:1518956358
Name:SANCHEZ HERNANDEZ, MARILYN (OD)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:
Last Name:SANCHEZ HERNANDEZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 CALLE DEL REY
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-5561
Mailing Address - Country:US
Mailing Address - Phone:877-246-6340
Mailing Address - Fax:787-246-6340
Practice Address - Street 1:371 CALLE DEL REY
Practice Address - Street 2:PASEOS REALES
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-246-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR410152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50092Medicare ID - Type Unspecified