MEDICARE: DR. RENE RAMON ECHEVARRIA-COFINO 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	208D00000X	General Practice Physician	6046	PR

General Provider Information

NPI Number	:	1053391201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENE RAMON ECHEVARRIA-COFINO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 361478
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-1478
Country	:	US
Telephone Number	:	787-756-6515
Fax Number	:	787-783-8378

Provider Business Practice Location Address
First Line	:	122 CALLE RODRIGO DE TRIANA
Second Line	:	EL VEDADO, HATO REY
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3206
Country	:	US
Telephone Number	:	787-756-6515
Fax Number	:	787-783-8378

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

Provider Enumeration Date	:	01/21/2006
Last Update Date	:	10/27/2010

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