Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | FL |
NPI | 1003360876 |
---|---|
Provider Name | Lillian Echevarria |
First Address | Tampa, FL 33629-5019 |
Second Address | Tampa, FL 33629-5019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2016 |
Last Update Date | 10/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
46-4611058 | SIN-CERA INC (01) | FL |