Provider Demographics
NPI:1770674574
Name:ANDREINA F HURTADO MD PA
Entity Type:Organization
Organization Name:ANDREINA F HURTADO MD PA
Other - Org Name:PINES OPHTHALMOLOGY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREINA
Authorized Official - Middle Name:F
Authorized Official - Last Name:HURTADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-433-5152
Mailing Address - Street 1:302 NW 179 AVENUE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029
Mailing Address - Country:US
Mailing Address - Phone:954-433-5152
Mailing Address - Fax:
Practice Address - Street 1:302 NW 179 AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029
Practice Address - Country:US
Practice Address - Phone:954-433-5152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11213201OtherCITRUS HEALTH CARE
FL56223OtherNHP
FL728759OtherAETNA
FL224581OtherEYE MED
FL4320OtherTOTAL HEALTH CHOICE
FL46513OtherSPECTRA
FL300124OtherAVMED
FL46513OtherSPECTRA