Provider Demographics
NPI:1801533021
Name:LAM ECHEVARRIA, DIDIER (RN)
Entity type:Individual
Prefix:
First Name:DIDIER
Middle Name:
Last Name:LAM ECHEVARRIA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 E 9TH ST APT 118
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4291
Mailing Address - Country:US
Mailing Address - Phone:786-448-7177
Mailing Address - Fax:
Practice Address - Street 1:4445 W 16TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7189
Practice Address - Country:US
Practice Address - Phone:305-558-8687
Practice Address - Fax:305-558-8097
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9549757163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult