Provider Demographics
NPI:1679937734
Name:RUBIANO LANDINEZ, ANDREA JULIETH
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:JULIETH
Last Name:RUBIANO LANDINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 SW 72ND AVE APT 1320
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7752
Mailing Address - Country:US
Mailing Address - Phone:517-410-1706
Mailing Address - Fax:
Practice Address - Street 1:1567 SAN REMO AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3008
Practice Address - Country:US
Practice Address - Phone:786-424-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS0552208000000X
390200000X
FLME162120208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program