Provider Demographics
NPI:1295119709
Name:ALBORNOZ, ANDRES ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:ANTONIO
Last Name:ALBORNOZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CORPORATE DR STE 100
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-6654
Mailing Address - Country:US
Mailing Address - Phone:561-299-5086
Mailing Address - Fax:561-925-8910
Practice Address - Street 1:1501 CORPORATE DR STE 100
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6654
Practice Address - Country:US
Practice Address - Phone:561-299-5086
Practice Address - Fax:561-925-8910
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN724207R00000X, 207RG0100X
PR19125207RG0100X, 207RI0008X
FLME139154207RG0100X, 207RI0008X, 207R00000X
FLACN 724207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatologyGroup - Multi-Specialty