Provider Demographics
NPI:1134455728
Name:SANCHEZ, JENNIFER YVETTE (LMT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:YVETTE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2674 N MCMULLEN BOOTH RD
Mailing Address - Street 2:APT. 1135
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-4407
Mailing Address - Country:US
Mailing Address - Phone:352-835-2337
Mailing Address - Fax:727-849-7685
Practice Address - Street 1:2674 N MCMULLEN BOOTH RD
Practice Address - Street 2:APT. 1135
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-4407
Practice Address - Country:US
Practice Address - Phone:352-835-2337
Practice Address - Fax:727-849-7685
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA34985225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist