Provider Demographics
NPI:1902851611
Name:ECHEVARRIA CARDONA, MARIA DE LOS A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:DE LOS A
Last Name:ECHEVARRIA CARDONA
Suffix:
Gender:F
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:PO BOX 1268
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1268
Mailing Address - Country:US
Mailing Address - Phone:787-735-0465
Mailing Address - Fax:787-735-0300
Practice Address - Street 1:165 CALLE BALDORIOTY N
Practice Address - Street 2:EDIFICIO CENTRAL OFIC. 6
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-0000
Practice Address - Country:US
Practice Address - Phone:787-735-0465
Practice Address - Fax:787-735-0300
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8537207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE599127Medicare UPIN