Provider Demographics
NPI:1770784662
Name:ECHEVARRIA, ANNETTE T (OTA)
Entity type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:T
Last Name:ECHEVARRIA
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:MS
Other - First Name:ANNETTE
Other - Middle Name:T
Other - Last Name:ECHEVARRIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTA
Mailing Address - Street 1:CARR174 URB.BRISAS DE PALMASOLA CALLE 5 CASA G-9
Mailing Address - Street 2:HC-03 BOX 16080
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703
Mailing Address - Country:US
Mailing Address - Phone:787-299-9648
Mailing Address - Fax:
Practice Address - Street 1:CARR174 URB.BRISAS DE PALMASOLA CALLE 5 CASA G-9
Practice Address - Street 2:
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703
Practice Address - Country:US
Practice Address - Phone:787-299-9648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PROTA 662247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other