Provider Demographics
NPI:1558369165
Name:REDONDO, ANDRES ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:ALEJANDRO
Last Name:REDONDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3181 SW 22 STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3216
Mailing Address - Country:US
Mailing Address - Phone:305-567-1999
Mailing Address - Fax:305-567-9309
Practice Address - Street 1:3181 SW 22 STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3216
Practice Address - Country:US
Practice Address - Phone:305-567-1999
Practice Address - Fax:305-567-9309
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0045903207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047898900Medicaid
FL05715ZMedicare PIN
FL047898900Medicaid