Healthcare Provider Details

I. General information

NPI: 1093791923
Provider Name (Legal Business Name): WIHELMA ECHEVARRIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PMB 509 - 7891 CLINICA LAS AMERICAS GUAYNABO
GUAYNABO PR
00970-2180
US

IV. Provider business mailing address

CALLE CARAZO #155 APTO 707 COND REGENCY PARK
GUAYNABO PR
00971-7805
US

V. Phone/Fax

Practice location:
  • Phone: 787-789-1919
  • Fax: 787-790-4047
Mailing address:
  • Phone: 787-647-7374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number14349
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: