Healthcare Provider Details

I. General information

NPI: 1417274481
Provider Name (Legal Business Name): ANDRES KRAUTHAMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD STE 2071
MIAMI BEACH FL
33140-2948
US

IV. Provider business mailing address

4306 ALTON RD
MIAMI BEACH FL
33140-2840
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2071
  • Fax: 305-535-7983
Mailing address:
  • Phone: 305-535-3349
  • Fax: 305-535-3438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number2804361
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME129372
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: