Provider Demographics
NPI:1962733360
Name:ECHEVARRIA MEDINA, ZORYMAR
Entity type:Individual
Prefix:DR
First Name:ZORYMAR
Middle Name:
Last Name:ECHEVARRIA MEDINA
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 1:8 URB ALTAMIRA
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669
Mailing Address - Country:US
Mailing Address - Phone:939-284-4800
Mailing Address - Fax:
Practice Address - Street 1:50 CALLE CABAN
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-544-6685
Practice Address - Fax:787-650-8717
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17803208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice