Provider Demographics
NPI:1699819987
Name:SANCHEZ, ANCIZAR (PT)
Entity Type:Individual
Prefix:
First Name:ANCIZAR
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17336 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5594
Mailing Address - Country:US
Mailing Address - Phone:305-595-5555
Mailing Address - Fax:305-592-6067
Practice Address - Street 1:8180 NW 36TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6645
Practice Address - Country:US
Practice Address - Phone:305-592-5555
Practice Address - Fax:305-592-6067
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 10455225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist