Provider Demographics
NPI:1144669326
Name:MORGADO-LAUREANO, ANDRES (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:
Last Name:MORGADO-LAUREANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ANDRES
Other - Middle Name:
Other - Last Name:MORGADO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1801 S PERIMETER RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-7140
Mailing Address - Country:US
Mailing Address - Phone:954-839-8080
Mailing Address - Fax:
Practice Address - Street 1:1600 S ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2510
Practice Address - Country:US
Practice Address - Phone:954-355-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME130672208D00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJ6OFSOtherBC BS
FLLM476OtherMEDICARE
FL103630400Medicaid