Healthcare Provider Details

I. General information

NPI: 1205168317
Provider Name (Legal Business Name): ANDREA PAPADIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2010
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 MICHIGAN AVE APT # 7
MIAMI FL
33139-3361
US

IV. Provider business mailing address

1500 MICHIGAN AVE APT #7
MIAMI FL
33139
US

V. Phone/Fax

Practice location:
  • Phone: 786-253-2206
  • Fax:
Mailing address:
  • Phone: 786-253-2206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN 10878
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: