MEDICARE: RAYNIER ECHEVARRIA, DCPA

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	111N00000X	Chiropractor	CH 7547	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1295932671	OTHER		CHIROPRACTIC

General Provider Information

NPI Number	:	1326403064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAYNIER ECHEVARRIA, DCPA

Provider Business Mailing Address
First Line	:	2851 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-3203
Country	:	US
Telephone Number	:	305-774-0104
Fax Number	:	305-774-0106

Provider Business Practice Location Address
First Line	:	2851 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-3203
Country	:	US
Telephone Number	:	305-774-0104
Fax Number	:	305-774-0106

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAYNIER ECHEVARRIA
Credential	:	DC
Telephone Number	:	305-774-0104

Provider Enumeration Date	:	12/23/2015
Last Update Date	:	12/23/2015

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