Provider Demographics
NPI:1679760680
Name:ANDUJAR ALEJANDRO, ALEX DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:DANIEL
Last Name:ANDUJAR ALEJANDRO
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 1:1877 FORTUNE RD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4428
Mailing Address - Country:US
Mailing Address - Phone:407-943-8600
Mailing Address - Fax:
Practice Address - Street 1:2622 SIMPSON RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4674
Practice Address - Country:US
Practice Address - Phone:407-943-8600
Practice Address - Fax:833-464-3621
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17940207Q00000X
FLACN1060207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine