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NPI Code Detail

MEDICARE: ELIZABETH M. ANDRESS, P.A.

MEDICARE: ELIZABETH M. ANDRESS, P.A.
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
1104100000XSocial WorkerSW9164FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z170WOTHERFLBCBS

General Provider Information

NPI Number : 1245559335
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELIZABETH M. ANDRESS, P.A.
Provider Business Mailing Address
First Line : 1975 E SUNRISE BLVD
Second Line : 629
City : FT LAUDERDALE
State : FL
Zip : 33304-1433
Country : US
Telephone Number : 305-790-4065
Fax Number :
Provider Business Practice Location Address
First Line : 1975 E SUNRISE BLVD
Second Line : 629
City : FT LAUDERDALE
State : FL
Zip : 33304-1433
Country : US
Telephone Number : 305-790-4065
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MS. ELIZABETH M ANDRESS
Credential : LCSW
Telephone Number : 305-790-4065
Provider Enumeration Date : 05/27/2010
Last Update Date : 05/27/2010

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