Provider Demographics
NPI:1558327403
Name:PRIETO-SANCHEZ, LUZ M (MD)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:M
Last Name:PRIETO-SANCHEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-5406
Mailing Address - Country:US
Mailing Address - Phone:850-224-7154
Mailing Address - Fax:850-561-0572
Practice Address - Street 1:1705 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-5406
Practice Address - Country:US
Practice Address - Phone:850-224-7154
Practice Address - Fax:850-561-0572
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93793207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273330700Medicaid
FLI41572Medicare UPIN
FL273330700Medicaid