Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | ME0049328 | FL |
NPI | 1356330252 |
---|---|
Provider Name | Jose Andrade |
First Address | Orlando, FL 32812-8522 |
Second Address | Orlando, FL 32812-8522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 02/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03722 | (02) | FL |
142941 | ONE HEALTH PLAN (01) | FL |
18251 | HEALTHEASE (01) | FL |
2000213 | GHI (01) | FL |
201227 | AMERIGROUP (01) | FL |
378451700 | (05) | FL |
47817071008 | CIGNA (01) | FL |
624969 | AETNA (01) | FL |
9274 | AVMED (01) | FL |