Provider Demographics
NPI:1386241404
Name:SANCHEZ, MARIELA
Entity type:Individual
Prefix:
First Name:MARIELA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 SONRISE SQ
Mailing Address - Street 2:
Mailing Address - City:FELLSMERE
Mailing Address - State:FL
Mailing Address - Zip Code:32948-5347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:62 SONRISE SQ
Practice Address - Street 2:
Practice Address - City:FELLSMERE
Practice Address - State:FL
Practice Address - Zip Code:32948-5347
Practice Address - Country:US
Practice Address - Phone:772-410-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty