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Individual

ANDRE TAMAYO CHELALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4302 ALTON RD STE 750, MIAMI BEACH, FL 33140-2893
(305) 674-6797
(305) 674-0784
Mailing address
4302 ALTON RD STE 750, MIAMI BEACH, FL 33140-2893
(305) 674-6797
(305) 674-0784

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS8197
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
037212
NHP
FL
01
110247108
RAILROAD MEDICARE
05
266357100
FL
01
273039
AVMED
01
3439201
AETNA
FL
01
51795
BCBS
FL
01
7688881
GHI
FL
01
N203914
WELLCARE
FL
Enumeration date
06/21/2006
Last updated
03/23/2022
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