MEDICARE: ANDREW MEDICAL SUPPLY INC

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	332BX2000X	Oxygen Equipment & Supplies (DME)	1312299	FL

General Provider Information

NPI Number	:	1467488643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW MEDICAL SUPPLY INC

Provider Business Mailing Address
First Line	:	4445 W 16TH AVE
Second Line	:	STE 606
City	:	HIALEAH
State	:	FL
Zip	:	33012-7189
Country	:	US
Telephone Number	:	305-821-9088
Fax Number	:	305-821-0208

Provider Business Practice Location Address
First Line	:	4445 W 16TH AVE
Second Line	:	STE 606
City	:	HIALEAH
State	:	FL
Zip	:	33012-7189
Country	:	US
Telephone Number	:	305-821-9088
Fax Number	:	305-821-0208

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDRES RODRIGUEZ
Credential	:
Telephone Number	:	305-821-9088

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	08/22/2020

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