Healthcare Provider Details

I. General information

NPI: 1285828533
Provider Name (Legal Business Name): OLGA L. ECHEVERRIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 08/08/2020
Certification Date: 08/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2771 EXECUTIVE PARK DR STE 1
WESTON FL
33331-3643
US

IV. Provider business mailing address

1812 VICTORIA POINTE CIR
WESTON FL
33327-1307
US

V. Phone/Fax

Practice location:
  • Phone: 954-251-0011
  • Fax: 954-251-0011
Mailing address:
  • Phone: 718-483-4340
  • Fax: 954-251-0011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME118569
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: