Provider Demographics
NPI:1841890464
Name:SANCHEZ, ALICE (RDN, LD/N)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:RDN, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7643 GATE PARKWAY
Mailing Address - Street 2:SUITE 104-1128
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7643 GATE PARKWAY
Practice Address - Street 2:SUITE 104-1128
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256
Practice Address - Country:US
Practice Address - Phone:941-451-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered