Provider Demographics
NPI:1083432868
Name:ECHEANDIA VARELA, JOSE FERNANDO
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:FERNANDO
Last Name:ECHEANDIA VARELA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 CALLE EDDIE GRACIA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2650
Mailing Address - Country:US
Mailing Address - Phone:787-425-9556
Mailing Address - Fax:
Practice Address - Street 1:526 CALLE EDDIE GRACIA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2650
Practice Address - Country:US
Practice Address - Phone:787-425-9556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer