Provider Demographics
NPI:1568523256
Name:ECHEVARRIA, EDDIE ISMAEL (RN)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:ISMAEL
Last Name:ECHEVARRIA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB VEREDAS
Mailing Address - Street 2:731 VEREDA DE LOS CEDROS
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-415-9097
Mailing Address - Fax:787-707-2280
Practice Address - Street 1:218 BROOK ST BLDG 21
Practice Address - Street 2:RODRIGUEZ ARMY HEALTH CLINIC
Practice Address - City:FORT BUCHANAN
Practice Address - State:PR
Practice Address - Zip Code:00934-4206
Practice Address - Country:US
Practice Address - Phone:787-707-2108
Practice Address - Fax:787-707-2280
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR030230163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical