Provider Demographics
NPI:1629106042
Name:GEORGE L SANCHEZ, MD
Entity Type:Organization
Organization Name:GEORGE L SANCHEZ, MD
Other - Org Name:REGIONAL PEDIATRICS AND NEWBORN CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-482-4655
Mailing Address - Street 1:3028 4TH ST
Mailing Address - Street 2:B
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-2127
Mailing Address - Country:US
Mailing Address - Phone:850-482-4655
Mailing Address - Fax:850-482-6694
Practice Address - Street 1:3028 4TH ST
Practice Address - Street 2:B
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-2127
Practice Address - Country:US
Practice Address - Phone:850-482-4655
Practice Address - Fax:850-482-6694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061139208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264885700Medicaid