Provider Demographics
NPI:1154916252
Name:SANCHEZ RODRIGUEZ, REBECA (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:SANCHEZ RODRIGUEZ
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2064 GLENLOCK DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-2309
Mailing Address - Country:US
Mailing Address - Phone:787-516-1435
Mailing Address - Fax:
Practice Address - Street 1:2064 GLENLOCK DR
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-2309
Practice Address - Country:US
Practice Address - Phone:787-516-1435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR930363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical