Basic Information
| Provider Information | |||||||||
| NPI: | 1013154863 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANCHEZ | ||||||||
| FirstName: | LEVY | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 S DELANEY AVE | ||||||||
| Address2: | #A-LL | ||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328061237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072670855 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12500 S APOPKA VINELAND RD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328366723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079342273 | ||||||||
| FaxNumber: | 4079342279 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2009 | ||||||||
| LastUpdateDate: | 01/15/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA 9100912 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | PA 9100912 | 01 | FL | LICENSE | OTHER |