Provider Demographics
NPI:1851377642
Name:SANCHEZ, MARK D (MD)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:D
Last Name:SANCHEZ
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2454 N MCMULLEN BOOTH RD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1353
Mailing Address - Country:US
Mailing Address - Phone:727-796-7705
Mailing Address - Fax:727-796-8764
Practice Address - Street 1:4726 N HABANA AVE
Practice Address - Street 2:STE 203
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7144
Practice Address - Country:US
Practice Address - Phone:813-933-9166
Practice Address - Fax:813-933-9596
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2016-06-27
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Provider Licenses
StateLicense IDTaxonomies
FLME 71673207VG0400X, 207VE0102X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256469600Medicaid
FL256469600Medicaid
FLG92346Medicare UPIN