Provider Demographics
NPI:1124672845
Name:SANCHEZ, PAOLO AUGUSTUS JABINES (PTA)
Entity type:Individual
Prefix:
First Name:PAOLO AUGUSTUS
Middle Name:JABINES
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:AUGUST
Other - Middle Name:JABINES
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUGUSTU SANCHEZ, PTA
Mailing Address - Street 1:1050 OLD CAMP RD STE 282
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-1762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1050 OLD CAMP RD STE 282
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-1762
Practice Address - Country:US
Practice Address - Phone:352-693-3378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA27270225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant