Provider Demographics
NPI:1912922311
Name:MEDEIROS, FELIPE ANDRADE (MD)
Entity Type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:ANDRADE
Last Name:MEDEIROS
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 1:1400 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1003
Mailing Address - Country:US
Mailing Address - Phone:305-689-5000
Mailing Address - Fax:305-689-4673
Practice Address - Street 1:1400 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1003
Practice Address - Country:US
Practice Address - Phone:305-689-5000
Practice Address - Fax:305-689-4673
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME164477207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI47522Medicare UPIN
CAWF5222AMedicare ID - Type Unspecified
CA000F52220Medicare ID - Type Unspecified