Provider Demographics
NPI:1427118165
Name:SANCHEZ, MANUEL (MD)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 LOCH NESS DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6012
Mailing Address - Country:US
Mailing Address - Phone:786-399-9944
Mailing Address - Fax:
Practice Address - Street 1:5385 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2101
Practice Address - Country:US
Practice Address - Phone:305-698-1215
Practice Address - Fax:305-698-1216
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0067711208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377284500Medicaid
FL377284500Medicaid
FL26732AMedicare ID - Type Unspecified