Provider Demographics
NPI:1912994781
Name:SANCHEZ, DANIEL PEDRO (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PEDRO
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 LEE BLVD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-1561
Mailing Address - Country:US
Mailing Address - Phone:123-930-3772
Mailing Address - Fax:
Practice Address - Street 1:2776 CLEVELAND AVE
Practice Address - Street 2:SUITE 8228
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-5864
Practice Address - Country:US
Practice Address - Phone:239-334-5837
Practice Address - Fax:239-334-5266
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13794207R00000X
FLME87329207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275242500Medicaid
FL53119OtherBCBS
FL275242500Medicaid
FL53119OtherBCBS
PRH60303Medicare UPIN