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General NPI Number Information
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NPI Number | 1366741746
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Entity Type | Individual
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Provider Name | MARIO ANDRES AZUERO M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 5350 UNIVERSITY PKWY STE 101
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City | SARASOTA
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State | FL
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Zip | 34243-5813
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Country | US
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Telephone | 941-917-4675
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Fax | 941-917-4688
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Provider Business Mailing Address
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Address Line | PO BOX 947407
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City | ATLANTA
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State | GA
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Zip | 30394-7407
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Country | US
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Telephone | 941-917-2600
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Fax | 941-917-7884
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-7803
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME128374
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License Number State | FL
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