Healthcare Provider Details

I. General information

NPI: 1922919257
Provider Name (Legal Business Name): MANUEL ALEJANDRO ANDINO HERRERA APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
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 Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11050964
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: