MEDICARE: GEORGE ANDRICOPOULOS M.D.

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
1	207Q00000X	Family Medicine Physician	ME82825	FL

General Provider Information

NPI Number	:	1265607501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE ANDRICOPOULOS M.D.

Provider Business Mailing Address
First Line	:	2010 S FEDERAL HWY APT I409
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6912
Country	:	US
Telephone Number	:	516-704-4854
Fax Number	:

Provider Business Practice Location Address
First Line	:	2010 S FEDERAL HWY APT I409
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6912
Country	:	US
Telephone Number	:	561-704-4854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	03/18/2019

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