Healthcare Provider Details

I. General information

NPI: 1093279382
Provider Name (Legal Business Name): ANDREA LOFAY MSN, APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 E STATE ROAD 64
BRADENTON FL
34208-5533
US

IV. Provider business mailing address

5215 SR 64 E
BRADENTON FL
34208
US

V. Phone/Fax

Practice location:
  • Phone: 941-907-3400
  • Fax:
Mailing address:
  • Phone: 941-907-3400
  • Fax: 941-907-4202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License NumberAPRN11001162
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11001162
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: