Provider Demographics
NPI:1962817163
Name:SANCHIOUS, ALYSON (MD)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:SANCHIOUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALYSON
Other - Middle Name:M
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3510 DR MARTIN LUTHER KING BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-4608
Mailing Address - Country:US
Mailing Address - Phone:239-402-8668
Mailing Address - Fax:239-310-2850
Practice Address - Street 1:3510 DR MARTIN LUTHER KING BLVD STE 3
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-4608
Practice Address - Country:US
Practice Address - Phone:239-402-8668
Practice Address - Fax:239-310-2850
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME126135207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023788000Medicaid
FLJG782ZOtherMEDICARE