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General NPI Number Information
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NPI Number | 1124095690
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Entity Type | Individual
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Provider Name | JOHN THOMAS ANDRONACO MD
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Gender | Male
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Dates
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Enumeration Date | 03/03/2006
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 28540 BURANO DR
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-8076
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Country | US
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Telephone | 201-960-7207
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Fax |
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Provider Business Mailing Address
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Address Line | 28540 BURANO DR
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-8076
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Country | US
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Telephone | 201-960-7207
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Fax |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME139073
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License Number State | FL
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