Healthcare Provider Details

I. General information

NPI: 1275417149
Provider Name (Legal Business Name): ANDREA CHRISTIE MAGEWICK APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA CHRISTIE REID RN

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13470 PARKER COMMONS BLVD STE 101
FORT MYERS FL
33912-1850
US

IV. Provider business mailing address

936 SW 28TH TER
CAPE CORAL FL
33914-4295
US

V. Phone/Fax

Practice location:
  • Phone: 239-379-8925
  • Fax:
Mailing address:
  • Phone: 586-668-1106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11041307
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: