Provider Demographics
NPI:1629278072
Name:DR SAMUEL SANCHEZ PSC
Entity Type:Organization
Organization Name:DR SAMUEL SANCHEZ PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-746-3136
Mailing Address - Street 1:PO BOX 6775
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6775
Mailing Address - Country:US
Mailing Address - Phone:787-746-3136
Mailing Address - Fax:787-745-1585
Practice Address - Street 1:200 GRAND BOULEVARD LOS PRADOS
Practice Address - Street 2:PLAZA LOS PRADOS SUITE Z-5
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-9507
Practice Address - Country:US
Practice Address - Phone:787-746-3136
Practice Address - Fax:787-745-1585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty