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General NPI Number Information
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NPI Number | 1568320323
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Entity Type | Individual
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Provider Name | ANDREA ELAINE SHORT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 2721 DEL PRADO BLVD S STE 100
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City | CAPE CORAL
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State | FL
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Zip | 33904-5782
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Country | US
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Telephone | 239-242-8010
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Fax |
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Provider Business Mailing Address
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Address Line | 5655 OCARINA RD
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City | NORTH PORT
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State | FL
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Zip | 34291-2208
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Country | US
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Telephone | 239-233-7949
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11044757
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License Number State | FL
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