Provider Demographics
NPI:1942849849
Name:GONZALEZ ECHEVARRIA, JOSHUA RAFAEL (CRNA)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:RAFAEL
Last Name:GONZALEZ ECHEVARRIA
Suffix:
Gender:M
Credentials:CRNA
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 3157
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-3157
Mailing Address - Country:US
Mailing Address - Phone:787-239-7449
Mailing Address - Fax:
Practice Address - Street 1:CALLE DOCTOR BARBOSA # 15
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00681
Practice Address - Country:US
Practice Address - Phone:787-834-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005124367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered