Basic Information
| Provider Information | |||||||||
| NPI: | 1033454491 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANCHEZ | ||||||||
| FirstName: | GABRIELA | ||||||||
| MiddleName: | ALEXANDRA | ||||||||
| NamePrefix: | |||||||||
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| Credential: | B.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30925 MERCEDES RD | ||||||||
| Address2: | |||||||||
| City: | BIG PINE KEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330434812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052978153 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3000 41ST STREET OCEAN | ||||||||
| Address2: | |||||||||
| City: | MARATHON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330502373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054347660 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2012 | ||||||||
| LastUpdateDate: | 12/11/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.