MEDICARE: JOSE ANDRADE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician	ME0049328	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2000213	OTHER	FL	GHI
2	9274	OTHER	FL	AVMED
3	201227	OTHER	FL	AMERIGROUP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	18251	OTHER	FL	HEALTHEASE
6	142941	OTHER	FL	ONE HEALTH PLAN
7	47817071008	OTHER	FL	CIGNA
8	624969	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1356330252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE ANDRADE M.D.

Provider Business Mailing Address
First Line	:	5412 CURRY FORD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-8522
Country	:	US
Telephone Number	:	407-658-7882
Fax Number	:	407-656-7995

Provider Business Practice Location Address
First Line	:	5412 CURRY FORD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-8522
Country	:	US
Telephone Number	:	407-658-7882
Fax Number	:	407-656-7995

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	10/02/2020

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