Healthcare Provider Details

I. General information

NPI: 1689630592
Provider Name (Legal Business Name): ANDRES GELRUD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9408 SW 87TH AVE STE 200
MIAMI FL
33176-2416
US

IV. Provider business mailing address

9500 S DADELAND BLVD 200
MIAMI FL
33156-2866
US

V. Phone/Fax

Practice location:
  • Phone: 305-913-0666
  • Fax:
Mailing address:
  • Phone: 305-468-4185
  • Fax: 305-675-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME131069
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: