Basic Information
| Provider Information | |||||||||
| NPI: | 1043532369 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANCHEZ CHAVEZ | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | JESUS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1545 NW 15TH STREET RD | ||||||||
| Address2: | 903 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331251612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058049326 | ||||||||
| FaxNumber: | 8886029306 | ||||||||
| Practice Location | |||||||||
| Address1: | 4011 W FLAGLER ST | ||||||||
| Address2: | 204 | ||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331341643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057741234 | ||||||||
| FaxNumber: | 3057741639 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2010 | ||||||||
| LastUpdateDate: | 03/31/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME115049 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 2084N0400X | ME115049 | FL | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084V0102X | ME115049 | FL | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 207Q00000X | ME115049 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | 50986 | CO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2084N0400X | 50986 | CO | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084V0102X | 50986 | CO | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 207Q00000X | 50986 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.