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General NPI Number Information
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NPI Number | 1487050837
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Entity Type | Individual
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Provider Name | ERNESTO ECHEVARRIA COTA/L
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Gender | Male
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 11/25/2019
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Provider Practice Location Address
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Address Line | 403 SW 148TH AVE APT 6
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1307
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Country | US
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Telephone | 786-426-7509
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Fax |
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Provider Business Mailing Address
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Address Line | 403 SW 148TH AVE APT 6
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1307
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Country | US
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Telephone | 786-426-7509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA 13717
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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