Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO3441 | FL |
NPI | 1083907083 |
---|---|
Provider Name | Alexandra Marie Andes |
First Address | Tamarac, FL 33321-2977 |
Second Address | Tamarac, FL 33321-2977 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2011 |
Last Update Date | 07/01/2014 |