Provider Demographics
NPI:1124176292
Name:ECHEVERRIA, LIZZETTE (RPH)
Entity type:Individual
Prefix:
First Name:LIZZETTE
Middle Name:
Last Name:ECHEVERRIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CALLE CENTRAL
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2110
Mailing Address - Country:US
Mailing Address - Phone:787-984-1008
Mailing Address - Fax:787-848-7117
Practice Address - Street 1:4 AVE. CENTRAL
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2110
Practice Address - Country:US
Practice Address - Phone:787-984-1008
Practice Address - Fax:787-848-7117
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4019356OtherNABP