Provider Demographics
NPI:1588195754
Name:SANCHEZ, TONI DENISE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:DENISE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11322 LAKELAND CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-6913
Mailing Address - Country:US
Mailing Address - Phone:239-410-3389
Mailing Address - Fax:
Practice Address - Street 1:13607 PINE VILLA LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-1617
Practice Address - Country:US
Practice Address - Phone:239-424-4041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9252646363L00000X
FL9252646363LP0808X
FLAPRN9252646363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020575600Medicaid