MEDICARE: MALGORZATA ANDRYC M.ED., ED.S

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
1	103TS0200X	School Psychologist	SS1911	FL

General Provider Information

NPI Number	:	1467308833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALGORZATA ANDRYC M.ED., ED.S

Provider Business Mailing Address
First Line	:	230 LIGE BRANCH LN
Second Line	:
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-7994
Country	:	US
Telephone Number	:	201-803-7430
Fax Number	:

Provider Business Practice Location Address
First Line	:	12276 SAN JOSE BLVD
Second Line	:	BUILDING 700, SUITE 718-6
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8628
Country	:	US
Telephone Number	:	201-803-7430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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