Provider Demographics
NPI:1033159835
Name:ANDINO, RENE (MD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:
Last Name:ANDINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 W 84TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4934
Mailing Address - Country:US
Mailing Address - Phone:305-826-9449
Mailing Address - Fax:305-828-1255
Practice Address - Street 1:3416 W 84TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-4923
Practice Address - Country:US
Practice Address - Phone:305-826-9449
Practice Address - Fax:305-828-1255
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME663842083B0002X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF92596Medicare UPIN