Provider Demographics
NPI:1285734756
Name:SANCHEZ, AIDA M (MD)
Entity type:Individual
Prefix:
First Name:AIDA
Middle Name:M
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 5000 PMB 697
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602
Mailing Address - Country:US
Mailing Address - Phone:787-603-1601
Mailing Address - Fax:
Practice Address - Street 1:AVE SEVERIANO CUEVAS #18
Practice Address - Street 2:AREA OFICINA PRIVADES
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-329-6725
Practice Address - Fax:787-819-1012
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12553170100000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR100154WOtherMEDICARE Y MUCHO MAS
PR89912OtherTRIPLE SSS
PR1250OtherPREFERRED MEDICARE CHOICE
PR6020062OtherHUMANA
PR3598OtherINTERNATIONAL MEDICAL CAR
PR1250OtherPREFERRED MEDICARE CHOICE