Provider Demographics
NPI:1427695519
Name:SANCHEZ, CARLA E
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:E
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 1:25230 SW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-6339
Mailing Address - Country:US
Mailing Address - Phone:786-773-4515
Mailing Address - Fax:
Practice Address - Street 1:25230 SW 107TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-6339
Practice Address - Country:US
Practice Address - Phone:786-773-4515
Practice Address - Fax:954-577-7780
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-08
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician