Provider Demographics
NPI:1952791287
Name:SANCHEZ-VIVALDI, JORGE ARMANDO (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:ARMANDO
Last Name:SANCHEZ-VIVALDI
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 1:155 CALLE CHELSEA
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-2718
Mailing Address - Country:US
Mailing Address - Phone:787-241-2190
Mailing Address - Fax:
Practice Address - Street 1:735 AVE PONCE DE LEON STE 375
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5025
Practice Address - Country:US
Practice Address - Phone:787-241-2190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18995208D00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice