Provider Demographics
NPI:1346766185
Name:ECHARTE ORTEGA, IVET FATIMA
Entity type:Individual
Prefix:
First Name:IVET FATIMA
Middle Name:
Last Name:ECHARTE ORTEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:684 HADLEY ST E
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-0882
Mailing Address - Country:US
Mailing Address - Phone:239-231-0320
Mailing Address - Fax:
Practice Address - Street 1:684 HADLEY ST E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-0882
Practice Address - Country:US
Practice Address - Phone:239-231-0320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLRBT-24369713106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician