Provider Demographics
NPI:1619116480
Name:ECHEVERRI, LUZ Y (MA)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:Y
Last Name:ECHEVERRI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LUZ
Other - Middle Name:Y
Other - Last Name:ECHEVERRI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:7489 ESTAGE COACHTRAIL
Mailing Address - Street 2:
Mailing Address - City:FLORAL CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34436
Mailing Address - Country:US
Mailing Address - Phone:352-419-4700
Mailing Address - Fax:352-419-4700
Practice Address - Street 1:7489 E STAGE COACH TRL
Practice Address - Street 2:7489 E STAGE COACH TRAIL
Practice Address - City:FLORAL CITY
Practice Address - State:FL
Practice Address - Zip Code:34436-3608
Practice Address - Country:US
Practice Address - Phone:352-419-4700
Practice Address - Fax:353-419-4700
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM.A 20706172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist