Healthcare Provider Details

I. General information

NPI: 1639562119
Provider Name (Legal Business Name): ANDREA PAOLA CONSUEGRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

15760 SW 153RD CT
MIAMI FL
33187-5497
US

V. Phone/Fax

Practice location:
  • Phone: 786-662-5465
  • Fax: 786-533-9246
Mailing address:
  • Phone: 786-370-2598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME165544
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: