Provider Demographics
NPI:1285631689
Name:MESSINA, ANDREW (MD)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:MESSINA
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 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:813-528-4975
Mailing Address - Fax:
Practice Address - Street 1:38135 MARKET SQ
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-7505
Practice Address - Country:US
Practice Address - Phone:813-782-8829
Practice Address - Fax:813-355-5099
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME565782085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00943865 - UCCOtherRR MEDICARE
FL064752700Medicaid
FLP00799260OtherRR MEDICARE
FL11617K - PASCOMedicare PIN
FL11617L - UCCMedicare PIN
FLP00799260OtherRR MEDICARE
FLP00943865 - UCCOtherRR MEDICARE