Healthcare Provider Details

I. General information

NPI: 1295119709
Provider Name (Legal Business Name): ANDRES ANTONIO ALBORNOZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2015
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 CORPORATE DR STE 100
BOYNTON BEACH FL
33426-6654
US

IV. Provider business mailing address

1501 CORPORATE DR STE 100 SUITE 100
BOYNTON BEACH FL
33426-6654
US

V. Phone/Fax

Practice location:
  • Phone: 561-299-5086
  • Fax: 561-925-8910
Mailing address:
  • Phone: 561-299-5086
  • Fax: 561-925-8910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberACN724
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME139154
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberACN724
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number19125
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberACN 724
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberME139154
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME139154
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number19125
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: