Healthcare Provider Details

I. General information

NPI: 1467953075
Provider Name (Legal Business Name): ANDRES MANUEL BIAGGI HERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2018
Last Update Date: 06/19/2023
Certification Date: 06/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 S VAL VISTA DR STE C202
GILBERT AZ
85297-7318
US

IV. Provider business mailing address

PO BOX 748860
ATLANTA GA
30374-8860
US

V. Phone/Fax

Practice location:
  • Phone: 480-633-6868
  • Fax: 480-633-6996
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number69622
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number14668-I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: