MEDICARE: ANDREW G DEL CARMINE

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	225100000X	Physical Therapist	0020858	CO
2	225100000X	Physical Therapist	13648	CT

General Provider Information

NPI Number	:	1760119119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW G DEL CARMINE

Provider Business Mailing Address
First Line	:	30940 STAGECOACH BLVD STE 110
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-7984
Country	:	US
Telephone Number	:	303-674-1594
Fax Number	:

Provider Business Practice Location Address
First Line	:	30940 STAGECOACH BLVD # 110
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-7984
Country	:	US
Telephone Number	:	303-674-1594
Fax Number	:

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

Provider Enumeration Date	:	08/05/2022
Last Update Date	:	12/24/2025

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