Provider Demographics
NPI:1902647217
Name:SANCHEZ DAVID, FERNANDO LUIS
Entity type:Individual
Prefix:
First Name:FERNANDO
Middle Name:LUIS
Last Name:SANCHEZ DAVID
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:HC 4 BOX 7524
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-9808
Mailing Address - Country:US
Mailing Address - Phone:787-568-7603
Mailing Address - Fax:
Practice Address - Street 1:HC 4 BOX 7524
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-9808
Practice Address - Country:US
Practice Address - Phone:787-568-7603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1278156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician