Provider Demographics
NPI:1346437415
Name:ANDREW B SHER MD PA
Entity Type:Organization
Organization Name:ANDREW B SHER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-787-4567
Mailing Address - Street 1:616 N PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-4417
Mailing Address - Country:US
Mailing Address - Phone:352-787-0370
Mailing Address - Fax:
Practice Address - Street 1:616 N PALMETTO ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-4417
Practice Address - Country:US
Practice Address - Phone:352-787-0370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265894100Medicaid
FL81933OtherBCBS OF FL
FLU0836ZMedicare PIN
FL265894100Medicaid
FLDD6198Medicare PIN
FLK8122Medicare PIN