Provider Demographics
NPI:1114262706
Name:SANDERS, ANDREA BETH (HAS, BC-HIS)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:BETH
Last Name:SANDERS
Suffix:
Gender:F
Credentials:HAS, BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 S FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1722
Mailing Address - Country:US
Mailing Address - Phone:954-437-1766
Mailing Address - Fax:954-437-6955
Practice Address - Street 1:306 S FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1722
Practice Address - Country:US
Practice Address - Phone:954-437-1766
Practice Address - Fax:954-437-6955
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4760237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist