Healthcare Provider Details

I. General information

NPI: 1104721448
Provider Name (Legal Business Name): ANDINO HEALTH EMPIRE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 NW NORTH RIVER DR APT A316
MIAMI FL
33125-2259
US

IV. Provider business mailing address

1901 NW NORTH RIVER DR APT A316
MIAMI FL
33125-2259
US

V. Phone/Fax

Practice location:
  • Phone: 786-340-7519
  • Fax:
Mailing address:
  • Phone: 786-340-7519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MANUEL ALEJANDRO ANDINO HERRERA
Title or Position: MANAGING MEMBER
Credential: MSN, APRN, FNP-C
Phone: 786-340-7519