Healthcare Provider Details

I. General information

NPI: 1194258350
Provider Name (Legal Business Name): ANDREW MICHAEL O'NEILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 LINTON BLVD STE 1A
DELRAY BEACH FL
33445-6501
US

IV. Provider business mailing address

4801 LINTON BLVD STE 1A
DELRAY BEACH FL
33445-6501
US

V. Phone/Fax

Practice location:
  • Phone: 561-708-4488
  • Fax:
Mailing address:
  • Phone: 561-708-4488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME156622
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: