MEDICARE: MR. ANDREW STAFFORD ARNP

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	363LF0000X	Family Nurse Practitioner	9207634	FL
2	363L00000X	Nurse Practitioner	9207634	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972887107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANDREW STAFFORD ARNP

Provider Business Mailing Address
First Line	:	5703 RED BUG LAKE RD # 166
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4969
Country	:	US
Telephone Number	:	407-948-9731
Fax Number	:

Provider Business Practice Location Address
First Line	:	5703 RED BUG LAKE RD
Second Line	:	# 166
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4969
Country	:	US
Telephone Number	:	407-948-9731
Fax Number	:

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

Provider Enumeration Date	:	10/06/2011
Last Update Date	:	03/21/2018

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