Provider Demographics
NPI:1932160090
Name:ZAMORA ECHEVARRIA, MARIA S
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:S
Last Name:ZAMORA ECHEVARRIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:DE LA SOLEDAD
Other - Last Name:ZAMORA ECHEVARRIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 190825
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-0825
Mailing Address - Country:US
Mailing Address - Phone:787-886-1311
Mailing Address - Fax:
Practice Address - Street 1:83 CALLE BETANCES
Practice Address - Street 2:VILLA CAROLINA
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-3241
Practice Address - Country:US
Practice Address - Phone:787-886-1311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10299174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG50687Medicare UPIN