Provider Demographics
NPI:1447862024
Name:REYES SANCHEZ, ESTHER LIDIA
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:LIDIA
Last Name:REYES 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 1:12160 SW 248 TERRACE
Mailing Address - Street 2:SAME AS ABOVE
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032
Mailing Address - Country:US
Mailing Address - Phone:786-236-9900
Mailing Address - Fax:
Practice Address - Street 1:12160 SW 248 TERRACE
Practice Address - Street 2:SAME AS ABOVE
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032
Practice Address - Country:US
Practice Address - Phone:786-236-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT1868765106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician