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General NPI Number Information
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NPI Number | 1750930731
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Entity Type | Individual
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Provider Name | ANDREA BERECZ-PREWITT
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Gender | Female
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 2400 HARBOR BLVD STE 7
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5038
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Country | US
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Telephone | 941-766-5095
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 917770
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City | ORLANDO
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State | FL
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Zip | 32891-0001
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Country | US
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Telephone | 813-821-8038
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9112497
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License Number State | FL
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