Healthcare Provider Details

I. General information

NPI: 1477852689
Provider Name (Legal Business Name): ANDREW JOHN COOKE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2011
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1936 SALK AVE
TAVARES FL
32778-4310
US

IV. Provider business mailing address

PO BOX 987
MOUNT DORA FL
32756-0987
US

V. Phone/Fax

Practice location:
  • Phone: 352-553-1717
  • Fax: 888-220-7924
Mailing address:
  • Phone: 352-553-1717
  • Fax: 888-220-7924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME118840
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME118840
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: