Provider Demographics
NPI:1104338151
Name:SANCHEZ, CARLOS M
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:M
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 W 28TH AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7227
Mailing Address - Country:US
Mailing Address - Phone:786-515-4437
Mailing Address - Fax:
Practice Address - Street 1:7730 W 28TH AVE APT 205
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-7227
Practice Address - Country:US
Practice Address - Phone:786-515-4437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician