Healthcare Provider Details

I. General information

NPI: 1487656070
Provider Name (Legal Business Name): ANDREW M NORRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 IMMOKALEE RD
NAPLES FL
34110-1401
US

IV. Provider business mailing address

1435 IMMOKALEE RD
NAPLES FL
34110-1401
US

V. Phone/Fax

Practice location:
  • Phone: 239-592-5511
  • Fax: 239-592-9259
Mailing address:
  • Phone: 239-592-5511
  • Fax: 239-592-9259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME151645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: