Healthcare Provider Details

I. General information

NPI: 1831590223
Provider Name (Legal Business Name): ANDREA HURTADO M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2014
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9016 SW 152ND ST
PALMETTO BAY FL
33157-1928
US

IV. Provider business mailing address

9016 SW 152ND ST
PALMETTO BAY FL
33157-1928
US

V. Phone/Fax

Practice location:
  • Phone: 305-238-8500
  • Fax: 305-251-4118
Mailing address:
  • Phone: 305-238-8500
  • Fax: 305-251-4118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: