Provider Demographics
NPI:1740860469
Name:SANCHEZ, RAFAEL ALBERTO (MS - CBHCMS)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ALBERTO
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MS - CBHCMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4613
Mailing Address - Country:US
Mailing Address - Phone:786-800-7190
Mailing Address - Fax:786-332-3999
Practice Address - Street 1:705 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4613
Practice Address - Country:US
Practice Address - Phone:786-800-7190
Practice Address - Fax:786-332-3999
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCMS101079171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator