Provider Demographics
NPI:1366828345
Name:ECHEVARRIA, LYNETTE (RPH)
Entity Type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:ECHEVARRIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR. 2 KM 45.6
Mailing Address - Street 2:PLAZA MONTE REAL
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-621-0486
Mailing Address - Fax:787-621-0490
Practice Address - Street 1:CARR 2 KM 45.6
Practice Address - Street 2:PLAZA MONTE REAL
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-0486
Practice Address - Fax:787-621-0490
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4856183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist