Healthcare Provider Details

I. General information

NPI: 1619400405
Provider Name (Legal Business Name): ANDREA MARIA ESTEVEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SW 73RD ST
SOUTH MIAMI FL
33143-4679
US

IV. Provider business mailing address

6200 SW 73 STREET BOX 69
MIAMI FL
33143
US

V. Phone/Fax

Practice location:
  • Phone: 786-662-5465
  • Fax: 786-662-5334
Mailing address:
  • Phone: 305-662-5465
  • Fax: 305-662-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME144050
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: