Provider Demographics
NPI:1801844717
Name:SANCHEZ, ROBERTO ENRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:ENRIQUE
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 942575
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2575
Mailing Address - Country:US
Mailing Address - Phone:305-456-7580
Mailing Address - Fax:786-536-5689
Practice Address - Street 1:1695 NW 110TH AVE
Practice Address - Street 2:STE 218
Practice Address - City:SWEETWATER
Practice Address - State:FL
Practice Address - Zip Code:33172-1929
Practice Address - Country:US
Practice Address - Phone:305-456-7580
Practice Address - Fax:786-536-5689
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME881622084N0400X
FL88162207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI 23125Medicare UPIN
FL46694Medicare ID - Type Unspecified