Provider Demographics
NPI:1083907083
Name:ANDES, ALEXANDRA MARIE (DPM)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MARIE
Last Name:ANDES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2977
Mailing Address - Country:US
Mailing Address - Phone:954-722-8080
Mailing Address - Fax:954-722-4093
Practice Address - Street 1:7421 N UNIVERSITY DR
Practice Address - Street 2:SUITE 304
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2977
Practice Address - Country:US
Practice Address - Phone:954-722-8080
Practice Address - Fax:954-722-4093
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3441213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery