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General NPI Number Information
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NPI Number | 1093725335
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Entity Type | Organization
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Legal Business Name | AGUSTINE A ANDRADE MD PA
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 4308 ALTON RD SUITE 310
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City | MIAMI BEACH
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State | FL
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Zip | 33140-4556
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Country | US
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Telephone | 305-672-7560
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Fax | 305-672-7936
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Provider Business Mailing Address
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Address Line | 4308 ALTON RD SUITE 310
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City | MIAMI BEACH
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State | FL
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Zip | 33140-4556
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Country | US
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Telephone | 305-672-7560
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Fax | 305-672-7936
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Authorized Official
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Title or Position | HEAD PHYSICIAN
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Name | AGUSTIN ANDRADE
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Credential | MD
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Telephone | 305-672-7560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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