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General NPI Number Information
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NPI Number | 1063073906
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Entity Type | Individual
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Provider Name | ANDREW LELCHUK DO
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Gender | Male
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 1601 CLINT MOORE RD STE 115
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City | BOCA RATON
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State | FL
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Zip | 33487-5712
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Country | US
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Telephone | 561-997-8484
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Fax | 561-997-8429
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Provider Business Mailing Address
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Address Line | 1601 CLINT MOORE RD STE 115
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City | BOCA RATON
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State | FL
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Zip | 33487-5712
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Country | US
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Telephone | 561-997-8484
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Fax | 561-997-8429
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25MB11636300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | OS20179
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS20179
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License Number State | FL
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