1811275720 NPI number — RAMON HUGO SANCHEZ, M.D., PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811275720 NPI number — RAMON HUGO SANCHEZ, M.D., PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAMON HUGO SANCHEZ, M.D., PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1811275720
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4600 N. HABANA AVE.
Provider Second Line Business Mailing Address:
SUITE 32
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-423-6515
Provider Business Mailing Address Fax Number:
813-569-7773

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4600 N HABANA AVE
Provider Second Line Business Practice Location Address:
SUITE 32
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33614-7112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-423-6515
Provider Business Practice Location Address Fax Number:
813-569-7773
Provider Enumeration Date:
07/26/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SANCHEZ
Authorized Official First Name:
RAMON
Authorized Official Middle Name:
HUGO
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
813-876-6677

Provider Taxonomy Codes

  • Taxonomy code: 202C00000X , with the licence number:  ACN395 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X , with the licence number: ACN395 , 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: 536239411315 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 12259143 . This is a "CAQH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 14EP9 . This is a "BC & BS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 016499300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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