Healthcare Provider Details

I. General information

NPI: 1609004902
Provider Name (Legal Business Name): ANDREW HEIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8725 HENDERSON RD
TAMPA FL
33634-1143
US

IV. Provider business mailing address

8725 HENDERSON RD
TAMPA FL
33634-1143
US

V. Phone/Fax

Practice location:
  • Phone: 813-540-0613
  • Fax:
Mailing address:
  • Phone: 813-540-0613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS11466
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: