Provider Demographics
NPI:1699730648
Name:SANCHEZ, FERNANDO DE JESUS (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:DE JESUS
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18300 NW 62 AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3306
Mailing Address - Country:US
Mailing Address - Phone:305-628-4600
Mailing Address - Fax:305-628-8090
Practice Address - Street 1:18300 NW 62 AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3306
Practice Address - Country:US
Practice Address - Phone:305-628-4600
Practice Address - Fax:305-628-8090
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51638207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371092102Medicaid
D67721Medicare UPIN
FL17959ZMedicare PIN