Provider Demographics
NPI:1205860723
Name:ECHEVARRIA, JAVIER ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:ENRIQUE
Last Name:ECHEVARRIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PARAISO DE COAMO 625 CALLE PAZ
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-9324
Mailing Address - Country:US
Mailing Address - Phone:787-409-9414
Mailing Address - Fax:
Practice Address - Street 1:LUIS MUNOZ MARIN AVE #138
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769
Practice Address - Country:US
Practice Address - Phone:787-803-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15429208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2812OtherAMERICAN HEALTH MEDICARE
PR22792ECOtherTRIPLE-S (SSS)
PR100788OtherCRUZ AZUL
PR992910OtherPREFERRED MEDICAL CHOICE
PR100788OtherCRUZ AZUL
PR992910OtherPREFERRED MEDICAL CHOICE