Provider Demographics
NPI:1700397551
Name:SANCHEZ, JACQUELINE YVETTE (APRN)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:YVETTE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1552 ORTEGA AVE
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-4902
Mailing Address - Country:US
Mailing Address - Phone:386-626-4656
Mailing Address - Fax:
Practice Address - Street 1:4401 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6946
Practice Address - Country:US
Practice Address - Phone:407-617-3217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3215734363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily