Healthcare Provider Details
I. General information
NPI: 1073315842
Provider Name (Legal Business Name): ANDRES A ALBORNOZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/25/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1501 CORPORATE DR SUITE 100
BOYNTON BEACH FL
33426-6654
US
IV. Provider business mailing address
4516 GULF SOUNDS LN
LAKE WORTH FL
33467-1108
US
V. Phone/Fax
- Phone: 561-907-1737
- Fax:
- Phone: 561-907-1737
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0008X |
| Taxonomy | Hepatology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANDRES
ANTONIO
ALBORNOZ
Title or Position: OWNER/ PHYSICIAN
Credential: MD
Phone: 561-907-1737