Provider Demographics
NPI:1639245442
Name:ECHEVERRY, JULIAN (MS)
Entity type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:
Last Name:ECHEVERRY
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 PEAK CIR.
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-6829
Mailing Address - Country:US
Mailing Address - Phone:407-222-5700
Mailing Address - Fax:
Practice Address - Street 1:1055 PEAK CIR.
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-6829
Practice Address - Country:US
Practice Address - Phone:407-222-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2198106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist