Provider Demographics
NPI:1982063178
Name:SANCHEZ, NELSON (MD)
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:
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 1:260 HIALEAH DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5219
Mailing Address - Country:US
Mailing Address - Phone:786-206-2888
Mailing Address - Fax:786-206-2889
Practice Address - Street 1:260 HIALEAH DR
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5219
Practice Address - Country:US
Practice Address - Phone:786-206-2888
Practice Address - Fax:786-685-2170
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME153783208D00000X
FLACN766208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111101100Medicaid