Healthcare Provider Details

I. General information

NPI: 1275453326
Provider Name (Legal Business Name): ELIZA ANDRUCZYK FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3065 NEW ENGLAND ST
SARASOTA FL
34231-7233
US

IV. Provider business mailing address

3065 NEW ENGLAND ST
SARASOTA FL
34231-7233
US

V. Phone/Fax

Practice location:
  • Phone: 224-805-7447
  • Fax:
Mailing address:
  • Phone: 224-805-7447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11049070
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: