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NPI Code Detail

MEDICARE: MR. GORDON SAMUEL ANDREWS JR. APRN

MEDICARE: MR. GORDON SAMUEL ANDREWS JR. APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LC0200XCritical Care Medicine Nurse Practitioner11048282FL
2163WC0200XCritical Care Medicine Registered NurseRN9710474FL

General Provider Information

NPI Number : 1174468615
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GORDON SAMUEL ANDREWS JR. APRN
Provider Business Mailing Address
First Line : 2261 CYPRESS CREEK ST
Second Line :
City : AUBURNDALE
State : FL
Zip : 33823-2268
Country : US
Telephone Number : 228-219-3229
Fax Number :
Provider Business Practice Location Address
First Line : 1900 DON WICKHAM DR
Second Line :
City : CLERMONT
State : FL
Zip : 34711-1979
Country : US
Telephone Number : 352-394-4071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2026
Last Update Date : 06/17/2026

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