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NPI Code Detail

MEDICARE: ANDRE LUIZ BEZERRA FNP

MEDICARE: ANDRE LUIZ BEZERRA FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAPRN11037737FL

General Provider Information

NPI Number : 1093528655
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRE LUIZ BEZERRA FNP
Provider Business Mailing Address
First Line : 4500 SAN PABLO RD S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-1865
Country : US
Telephone Number : 904-953-2000
Fax Number :
Provider Business Practice Location Address
First Line : 4500 SAN PABLO RD S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-1865
Country : US
Telephone Number : 904-953-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2025
Last Update Date : 03/24/2026

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Directions to “ ANDRE LUIZ BEZERRA FNP” Practice Location

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