Provider Demographics
NPI:1922186790
Name:SANCHEZ MALDONADO, HECTOR L (OD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:L
Last Name:SANCHEZ MALDONADO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 5A MARG. K1 URB. VILLA REAL
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-0000
Mailing Address - Country:US
Mailing Address - Phone:787-462-0573
Mailing Address - Fax:787-858-2624
Practice Address - Street 1:CALLE 5A MARG K1 URB VILLA REAL
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-0000
Practice Address - Country:US
Practice Address - Phone:787-858-2624
Practice Address - Fax:787-858-2624
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR138152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5-8250Medicare UPIN