Individual
ANDREA DALE MADERAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-5215
Mailing address
1611 NW 12TH AVE, CENTRAL 600D, MIAMI, FL 33136-1005
(305) 585-5215
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME131919
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2013
Last updated
07/10/2017
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