Provider Demographics
NPI:1083838106
Name:FERBER, ANDREW SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SAMUEL
Last Name:FERBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11932 FAIRWAY LAKES DR STE 1
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8337
Mailing Address - Country:US
Mailing Address - Phone:239-237-2801
Mailing Address - Fax:239-771-8327
Practice Address - Street 1:11932 FAIRWAY LAKES DR STE 1
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8337
Practice Address - Country:US
Practice Address - Phone:239-237-2801
Practice Address - Fax:239-771-8327
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086321-12084P0800X
FLME1088242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003513100Medicaid