Provider Demographics
NPI:1124876560
Name:SANCHEZ, SAMANTHA CHRISTINA (MS, RD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:CHRISTINA
Last Name:SANCHEZ
Suffix:
Gender:
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4342 NW 112TH CT
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4388
Mailing Address - Country:US
Mailing Address - Phone:305-798-9327
Mailing Address - Fax:
Practice Address - Street 1:4342 NW 112TH CT
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4388
Practice Address - Country:US
Practice Address - Phone:305-798-9327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND10050133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered