MEDICARE: MARIA I ANDRAKOVICH MD

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME21436	FL

General Provider Information

NPI Number	:	1770689259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA I ANDRAKOVICH MD

Provider Business Mailing Address
First Line	:	6900 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-4612
Country	:	US
Telephone Number	:	561-389-1331
Fax Number	:

Provider Business Practice Location Address
First Line	:	6900 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-4612
Country	:	US
Telephone Number	:	561-389-1331
Fax Number	:

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	07/08/2007

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