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

Table of content: (NPI 1811275720)

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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