Provider Demographics
NPI:1629325584
Name:SANCHEZ ACOSTA, YISSELL (OD)
Entity Type:Individual
Prefix:DR
First Name:YISSELL
Middle Name:
Last Name:SANCHEZ ACOSTA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:YISSELL
Other - Middle Name:
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:3502 KYOTO GARDENS DR STE B
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2899
Mailing Address - Country:US
Mailing Address - Phone:561-630-7120
Mailing Address - Fax:
Practice Address - Street 1:3502 KYOTO GARDENS DR STE B
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2899
Practice Address - Country:US
Practice Address - Phone:561-630-7120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4713152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist