Provider Demographics
NPI:1639540214
Name:DR JOSE JESUS SANCHEZ MD PA
Entity Type:Organization
Organization Name:DR JOSE JESUS SANCHEZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-804-9326
Mailing Address - Street 1:1841 SW 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-1607
Mailing Address - Country:US
Mailing Address - Phone:305-804-9326
Mailing Address - Fax:888-602-9306
Practice Address - Street 1:4011 W FLAGLER ST
Practice Address - Street 2:SUITE 2014
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1643
Practice Address - Country:US
Practice Address - Phone:305-774-1234
Practice Address - Fax:305-774-1639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center