Provider Demographics
NPI:1770104176
Name:SANCHEZ, DARIEL (PTA)
Entity type:Individual
Prefix:
First Name:DARIEL
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 47TH ST W APT 113
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2824
Mailing Address - Country:US
Mailing Address - Phone:941-405-9985
Mailing Address - Fax:
Practice Address - Street 1:4550 47TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2888
Practice Address - Country:US
Practice Address - Phone:941-405-9985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant