Provider Demographics
NPI:1649551862
Name:SANCHEZ, BRUNILDA
Entity type:Individual
Prefix:DR
First Name:BRUNILDA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 AVE ARTERIAL HOSTOS
Mailing Address - Street 2:CONDO GOLDEN CT 2 BOX 239
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2987
Mailing Address - Country:US
Mailing Address - Phone:787-674-4172
Mailing Address - Fax:
Practice Address - Street 1:WALGREENS #0156
Practice Address - Street 2:5984 ISLA VERDE AVENUE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-982-0390
Practice Address - Fax:787-982-0570
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002260111NX0100X
PR002060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
No183500000XPharmacy Service ProvidersPharmacist