Provider Demographics
NPI:1306949342
Name:ECHEANDIA FUSTER, FERNANDO (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:
Last Name:ECHEANDIA FUSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1792
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-1792
Mailing Address - Country:US
Mailing Address - Phone:787-897-5683
Mailing Address - Fax:
Practice Address - Street 1:CARR 111 KM 4.2
Practice Address - Street 2:LARES
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:787-897-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11273207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1077OtherPREFERRED MEDICARE CHOISE
PR83632Other83632
PR100160WOtherMMM
PR7059OtherINTERNATIONAL MEDICAL CAR
PR3377-5OtherASOCIACION DE MAESTROS
PR3377-5OtherASOCIACION DE MAESTROS
PR83632Medicare ID - Type UnspecifiedMEDICARE