Basic Information
Provider Information
NPI: 1326340696
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANCHEZ
FirstName: ARELYS
MiddleName:  
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NameSuffix:  
Credential:  
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Mailing Information
Address1: 6817 N HABANA AVE LOT 41
Address2:  
City: TAMPA
State: FL
PostalCode: 336144371
CountryCode: US
TelephoneNumber: 8137708485
FaxNumber:  
Practice Location
Address1: 708 PEARL CIR
Address2:  
City: BRANDON
State: FL
PostalCode: 335104246
CountryCode: US
TelephoneNumber: 8133910235
FaxNumber: 8136554814
Other Information
ProviderEnumerationDate: 11/18/2010
LastUpdateDate: 11/18/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
222Q00000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist 

No ID Information.


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