Healthcare Provider Details

I. General information

NPI: 1962085472
Provider Name (Legal Business Name): EDUARDO INACIO NASCIMENTO ANDRADE M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1264 ROCKLEDGE BLVD STE 101
ROCKLEDGE FL
32955-2746
US

IV. Provider business mailing address

60 FENWOOD RD
BOSTON MA
02115-6128
US

V. Phone/Fax

Practice location:
  • Phone: 321-345-6331
  • Fax: 321-345-3295
Mailing address:
  • Phone: 617-732-7432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME176142
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number1022302
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: