Provider Demographics
NPI:1699442863
Name:PALMERO SANCHEZ, JUAN LUIS
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:LUIS
Last Name:PALMERO SANCHEZ
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 1:491 W 32ND PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5345
Mailing Address - Country:US
Mailing Address - Phone:786-277-3833
Mailing Address - Fax:
Practice Address - Street 1:491 W 32ND PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5345
Practice Address - Country:US
Practice Address - Phone:786-277-3833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician