MEDICARE: DR. JOSE J ECHEGARAY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	ME136587	FL
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	ME136587	FL

General Provider Information

NPI Number	:	1205275229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE J ECHEGARAY M.D.

Provider Business Mailing Address
First Line	:	1187 TADSWORTH TER
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5330
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	616 E ALTAMONTE DR STE 101
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-4811
Country	:	US
Telephone Number	:	407-637-2096
Fax Number	:	407-637-2097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2013
Last Update Date	:	04/27/2024

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