Provider Demographics
NPI:1245007533
Name:ECHEVARRIA FELICIANO, ADALBERTO
Entity type:Individual
Prefix:
First Name:ADALBERTO
Middle Name:
Last Name:ECHEVARRIA FELICIANO
Suffix:
Gender:
Credentials:
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 297
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0297
Mailing Address - Country:US
Mailing Address - Phone:939-319-5343
Mailing Address - Fax:
Practice Address - Street 1:GOLDEN PLAZA SUITE #3
Practice Address - Street 2:CARRETERA 402 KM 2.1 BARRIO MARIAS
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:939-319-5343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR023904208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice