Provider Demographics
NPI:1295500627
Name:OUTLAST HEALTH P.A
Entity type:Organization
Organization Name:OUTLAST HEALTH P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ECHEVERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-903-8072
Mailing Address - Street 1:550 W 54TH ST APT 2120
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-4725
Mailing Address - Country:US
Mailing Address - Phone:646-925-7037
Mailing Address - Fax:
Practice Address - Street 1:550 W 54TH ST APT 2120
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4725
Practice Address - Country:US
Practice Address - Phone:646-925-7037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care MedicineGroup - Multi-Specialty