1265457725 NPI number — MS. CYNTHIA DIAZ SANCHEZ L.C.S.W.

Table of content: DAVID A NOWAK (NPI 1013126259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265457725 NPI number — MS. CYNTHIA DIAZ SANCHEZ L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANCHEZ
Provider First Name:
CYNTHIA
Provider Middle Name:
DIAZ
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265457725
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5121 EHRLICH RD
Provider Second Line Business Mailing Address:
SUITE 104-B
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33624-2049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-968-8801
Provider Business Mailing Address Fax Number:
813-960-9373

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5121 EHRLICH RD
Provider Second Line Business Practice Location Address:
SUITE 104-B
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33624-2049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-968-8801
Provider Business Practice Location Address Fax Number:
813-960-9373
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW 2548 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: FL 2256 . This is a "UNIPSYCH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: SANCCYNT . This is a "LIFESYNCH - CORPHEALTH (HUMANA)" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 11614783 . This is a "CAQH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2165768 . This is a "COMPSYCH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 282088 . This is a "VALUE OPTIONS PROVIDER ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 20919 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 501699693 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 7244935 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Z4609 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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