Provider Demographics
NPI:1316269376
Name:SANCHEZ, JUAN L (BS)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:L
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15411 SW 36TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4788
Mailing Address - Country:US
Mailing Address - Phone:786-424-0606
Mailing Address - Fax:
Practice Address - Street 1:2400 SW 137TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6311
Practice Address - Country:US
Practice Address - Phone:305-456-0572
Practice Address - Fax:786-980-5700
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCMS100100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker