Healthcare Provider Details

I. General information

NPI: 1154678811
Provider Name (Legal Business Name): ANDREA K THET M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA THET MD

II. Dates (important events)

Enumeration Date: 08/12/2012
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N FEDERAL HWY # 221A
BOCA RATON FL
33432-2803
US

IV. Provider business mailing address

1200 N FEDERAL HWY # 221A
BOCA RATON FL
33432-2803
US

V. Phone/Fax

Practice location:
  • Phone: 561-961-0845
  • Fax: 561-961-0905
Mailing address:
  • Phone: 561-961-0845
  • Fax: 561-961-0905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME167175
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: