MEDICARE: DR. ANDREW E NULLMAN 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	207RG0100X	Gastroenterology Physician	ME51981	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1912939208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW E NULLMAN M.D.

Provider Business Mailing Address
First Line	:	1190 NW 95TH ST STE 412
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33150-2067
Country	:	US
Telephone Number	:	305-534-4404
Fax Number	:	305-691-4449

Provider Business Practice Location Address
First Line	:	1190 NW 95TH ST STE 412
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33150-2067
Country	:	US
Telephone Number	:	305-534-4404
Fax Number	:	305-691-4449

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	11/08/2021

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