Provider Demographics
NPI:1093155392
Name:HEGEDUS, ANDREEA LAURA
Entity Type:Individual
Prefix:MS
First Name:ANDREEA
Middle Name:LAURA
Last Name:HEGEDUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6930 NW 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2330
Mailing Address - Country:US
Mailing Address - Phone:561-843-6091
Mailing Address - Fax:
Practice Address - Street 1:6930 NW 3RD AVE
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2330
Practice Address - Country:US
Practice Address - Phone:561-843-6091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA24001225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant