Provider Demographics
NPI:1568588952
Name:ANDAYA, SERJUN CASTRO (MD)
Entity Type:Individual
Prefix:DR
First Name:SERJUN
Middle Name:CASTRO
Last Name:ANDAYA
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 1:2263 SW 37TH AVE
Mailing Address - Street 2:#433
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3275
Mailing Address - Country:US
Mailing Address - Phone:213-675-0129
Mailing Address - Fax:
Practice Address - Street 1:215 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33133-4841
Practice Address - Country:US
Practice Address - Phone:305-441-7179
Practice Address - Fax:305-448-7134
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV139582080N0001X
FLME 1233542080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVLL1556OtherMEDICAL LICENSE
NVASO2532199105OtherDEA CERTIFICATE