Provider Demographics
NPI:1477801843
Name:ANDREWS, REBECCA LEIGH (PA)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LEIGH
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:LEIGH
Other - Last Name:LEBLANC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4646
Mailing Address - Country:US
Mailing Address - Phone:850-216-0100
Mailing Address - Fax:850-216-0112
Practice Address - Street 1:1300 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4646
Practice Address - Country:US
Practice Address - Phone:850-216-0100
Practice Address - Fax:850-216-0112
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106668363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGK210ZOtherMEDICARE PTAN
FL006344300Medicaid