Provider Demographics
NPI:1124530225
Name:AMADEO SANCHEZ, WALDO ALBERTO
Entity type:Individual
Prefix:
First Name:WALDO
Middle Name:ALBERTO
Last Name:AMADEO 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 1:27499 RIVERVIEW CENTER BLVD STE 242
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-4335
Mailing Address - Country:US
Mailing Address - Phone:239-955-1355
Mailing Address - Fax:
Practice Address - Street 1:27499 RIVERVIEW CENTER BLVD STE 242
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-4335
Practice Address - Country:US
Practice Address - Phone:239-955-1355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-30
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12330111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor