Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA90082 | FL |
N | 226300000X | Kinesiotherapist | MA90082 | FL |
NPI | 1134684251 |
---|---|
Provider Name | Joshua D Sanchez |
First Address | Boynton Beach, FL 33436-7128 |
Second Address | Royal Palm Beach, FL 33411-1669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2019 |
Last Update Date | 02/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MA90082 | (05) | FL |
MA90082 | LMT (01) | FL |