Provider Demographics
NPI:1740204130
Name:AMUNATEGUI, ANDREW P (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:P
Last Name:AMUNATEGUI
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 1:21355 E DIXIE HWY STE 109
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1239
Mailing Address - Country:US
Mailing Address - Phone:305-931-9316
Mailing Address - Fax:305-932-5910
Practice Address - Street 1:21355 E DIXIE HWY STE 109
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1239
Practice Address - Country:US
Practice Address - Phone:305-931-9316
Practice Address - Fax:305-932-5910
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73972208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
42293Medicare ID - Type Unspecified
FLG63660Medicare UPIN