MEDICARE: DR. WERNER ALFREDO ANDRADE ORTIZ 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	208600000X	Surgery Physician	ME117468	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z138906	OTHER	AZ	PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366616484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WERNER ALFREDO ANDRADE ORTIZ M.D.

Provider Business Mailing Address
First Line	:	2801 NW 79TH AVE STE 407
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33122-1174
Country	:	US
Telephone Number	:	786-320-5022
Fax Number	:	786-320-5088

Provider Business Practice Location Address
First Line	:	2801 NW 79TH AVE STE 407
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33122-1174
Country	:	US
Telephone Number	:	786-320-5022
Fax Number	:	786-320-5088

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

Provider Enumeration Date	:	04/18/2008
Last Update Date	:	01/24/2025

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