Provider Demographics
NPI:1346658481
Name:CRAIG, ANDREW
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:CRAIG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 SHERIDAN ST STE A
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3552
Mailing Address - Country:US
Mailing Address - Phone:754-201-1340
Mailing Address - Fax:732-918-1678
Practice Address - Street 1:4420 SHERIDAN ST STE A
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3552
Practice Address - Country:US
Practice Address - Phone:754-201-1340
Practice Address - Fax:732-918-1678
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17897225XH1200X
NJ46TR00661400225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand