Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME87094 | FL |
N | 111NI0900X | Internist | ME87094 | FL |
N | 207RC0200X | Critical Care Medicine | ME87094 | FL |
Y | 207RP1001X | Pulmonary Disease | ME87094 | FL |
NPI | 1043232028 |
---|---|
Provider Name | Luis Jorge Echarte |
First Address | Miami, FL 33196-1159 |
Second Address | Aventura, FL 33180-1227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 02/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
277032600 | (05) | FL |
31064 | BLUE CROSS BLUE SHIELD (01) | FL |