Healthcare Provider Details

I. General information

NPI: 1093766040
Provider Name (Legal Business Name): ANDREW MICHAEL LOFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 04/26/2025
Certification Date: 04/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 NW 107TH AVE STE 115
MIAMI FL
33172-3104
US

IV. Provider business mailing address

42450 W 12 MILE RD STE 100
NOVI MI
48377-3011
US

V. Phone/Fax

Practice location:
  • Phone: 786-607-8979
  • Fax:
Mailing address:
  • Phone: 248-540-2100
  • Fax: 248-540-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number4301083297
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME168028
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: