Provider Demographics
NPI:1124001235
Name:TRESCOT, ANDREA MARGARET (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARGARET
Last Name:TRESCOT
Suffix:
Gender:F
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:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:EAST PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32131-0062
Mailing Address - Country:US
Mailing Address - Phone:904-806-6166
Mailing Address - Fax:
Practice Address - Street 1:147 DANCY AVE
Practice Address - Street 2:
Practice Address - City:EAST PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32131-4339
Practice Address - Country:US
Practice Address - Phone:904-806-6166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53281207LP2900X, 2083A0300X
AK7474208VP0014X
FLME0053281208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD0327WMedicaid
FL11376OtherBLUE CROSS
FL277978100Medicaid
FL277978100Medicaid
FL11376PMedicare PIN
FL11376RMedicare PIN
FLE60473Medicare UPIN
FL11376OtherBLUE CROSS
AK1008129Medicaid
AKK164534Medicare PIN