Provider Demographics
NPI:1346297348
Name:BASILE, ANDREW MICHAEL (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:MICHAEL
Last Name:BASILE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3550 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 409
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3841
Mailing Address - Country:US
Mailing Address - Phone:305-576-5505
Mailing Address - Fax:305-576-5585
Practice Address - Street 1:3550 BISCAYNE BLVD
Practice Address - Street 2:SUITE 409
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3841
Practice Address - Country:US
Practice Address - Phone:305-576-5505
Practice Address - Fax:305-576-5585
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2024-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS8508207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E18549Medicare UPIN