Provider Demographics
NPI:1659425965
Name:SANCHEZ, MANUEL (OPTOMETRIST)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DE DIEGO 322
Mailing Address - Street 2:STOP 22
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00909
Mailing Address - Country:US
Mailing Address - Phone:787-723-0946
Mailing Address - Fax:787-723-0946
Practice Address - Street 1:DE DIEGO 322
Practice Address - Street 2:STOP 22
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-723-0946
Practice Address - Fax:787-723-0946
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR121152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist