Provider Demographics
NPI:1811331291
Name:ECHEVERRIA, SATURNINO (APRN)
Entity type:Individual
Prefix:MR
First Name:SATURNINO
Middle Name:
Last Name:ECHEVERRIA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 S US 301 STE B
Mailing Address - Street 2:
Mailing Address - City:SUMTERVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:33585-5355
Mailing Address - Country:US
Mailing Address - Phone:352-569-4980
Mailing Address - Fax:352-569-4981
Practice Address - Street 1:617 S US 301 STE B
Practice Address - Street 2:
Practice Address - City:SUMTERVILLE
Practice Address - State:FL
Practice Address - Zip Code:33585-5355
Practice Address - Country:US
Practice Address - Phone:352-569-4980
Practice Address - Fax:352-569-4981
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2024-07-10
Deactivation Date:2023-06-07
Deactivation Code:
Reactivation Date:2024-07-09
Provider Licenses
StateLicense IDTaxonomies
FL11033350363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty