Provider Demographics
NPI:1639581903
Name:COOMBS, ANDRE VICTOR (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:VICTOR
Last Name:COOMBS
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 1:11760 SW 40TH ST STE 722
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-8101
Mailing Address - Country:US
Mailing Address - Phone:305-559-1883
Mailing Address - Fax:305-559-1887
Practice Address - Street 1:55 WHITCHER ST NE STE 130
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1156
Practice Address - Country:US
Practice Address - Phone:770-428-0462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146025208600000X
GA1024682086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care