Provider Demographics
NPI:1073733317
Name:ANDINO, IRMA (BSN)
Entity Type:Individual
Prefix:MR
First Name:IRMA
Middle Name:
Last Name:ANDINO
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 34 AE 10
Mailing Address - Street 2:TERRAZAS DE CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-763-7521
Mailing Address - Fax:787-763-2480
Practice Address - Street 1:CALLE 34 AE 10
Practice Address - Street 2:TERRAZAS DE CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-763-7521
Practice Address - Fax:787-763-2480
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9340163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse