Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME61527 | FL |
N | 111NI0900X | Internist | ME61527 | FL |
Y | 207RN0300X | Nephrologist | ME61527 | FL |
NPI | 1053308338 |
---|---|
Provider Name | Mr. Diego Echeverri |
First Address | Lauderdale Lakes, FL 33313 |
Second Address | Lauderdale Lakes, FL 33313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 22/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
370037200 | (05) | FL |
AMERIGROUP | 200500 (01) | FL |
AVMED | 217042 (01) | FL |
BCBS | 14795 (01) | FL |
CAREPLUS | 1000611 (01) | FL |
F24873 | (02) | |
F24873 | (02) | FL |