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NPI Code Detail

MEDICARE: ANDREW J TUCKER DO

MEDICARE:   ANDREW J TUCKER  DO
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
1207L00000XAnesthesiology Physician1215566492FL
2207R00000XInternal Medicine Physician207R00000XFL
3207L00000XAnesthesiology PhysicianOS025269PA
4207L00000XAnesthesiology Physician81845WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215566492
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW J TUCKER DO
Provider Business Mailing Address
First Line : 2125 BISCAYNE BLVD STE 204
Second Line :
City : MIAMI
State : FL
Zip : 33137-5029
Country : US
Telephone Number : 850-509-8576
Fax Number :
Provider Business Practice Location Address
First Line : 160 NW 170TH ST
Second Line :
City : NORTH MIAMI BEACH
State : FL
Zip : 33169-5521
Country : US
Telephone Number : 305-651-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2020
Last Update Date : 06/22/2026

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Directions to “ ANDREW J TUCKER DO” Practice Location

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