Provider Demographics
NPI:1053391201
Name:ECHEVARRIA-COFINO, RENE RAMON (MD)
Entity type:Individual
Prefix:DR
First Name:RENE
Middle Name:RAMON
Last Name:ECHEVARRIA-COFINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RENE
Other - Middle Name:RAMON
Other - Last Name:ECHEVARRIA-COFINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 361478
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1478
Mailing Address - Country:US
Mailing Address - Phone:787-756-6515
Mailing Address - Fax:787-783-8378
Practice Address - Street 1:122 CALLE RODRIGO DE TRIANA
Practice Address - Street 2:EL VEDADO, HATO REY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3206
Practice Address - Country:US
Practice Address - Phone:787-756-6515
Practice Address - Fax:787-783-8378
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-21
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6046208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC-79653Medicare ID - Type UnspecifiedMEDICARE