MEDICARE: ROLANDA ANDRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	ARNP9358264	FL

General Provider Information

NPI Number	:	1487059218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROLANDA ANDRE

Provider Business Mailing Address
First Line	:	13100 NE 3RD CT
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-3909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13100 NE 3RD CT
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-3909
Country	:	US
Telephone Number	:	954-446-5638
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	ROLANDA DESIR ANDRE
Credential	:	FNP
Telephone Number	:	954-446-5638

Provider Enumeration Date	:	10/22/2014
Last Update Date	:	10/22/2014

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