Provider Demographics
NPI:1588264980
Name:SANCHEZ-REAL, DAVID EDGARDO
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:EDGARDO
Last Name:SANCHEZ-REAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 14030
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-9522
Mailing Address - Country:US
Mailing Address - Phone:787-414-5576
Mailing Address - Fax:
Practice Address - Street 1:URB VILLA BLANCA CLL JADE
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-414-5576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program