Provider Demographics
NPI:1457542953
Name:CARLOS SANCHEZ OD PA
Entity Type:Organization
Organization Name:CARLOS SANCHEZ OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:239-992-7711
Mailing Address - Street 1:2223 SW 51ST ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-3001
Mailing Address - Country:US
Mailing Address - Phone:239-560-1571
Mailing Address - Fax:
Practice Address - Street 1:8076 MEDITERRANEAN DR
Practice Address - Street 2:SUITE 115
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-8317
Practice Address - Country:US
Practice Address - Phone:239-992-7711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3050261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center