Provider Demographics
NPI:1477841336
Name:CAESAR, ANDREA FLO (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:FLO
Last Name:CAESAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1376 GREENRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-2210
Mailing Address - Country:US
Mailing Address - Phone:678-488-3902
Mailing Address - Fax:
Practice Address - Street 1:6254 MEMORIAL DR STE F
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-2884
Practice Address - Country:US
Practice Address - Phone:770-588-1029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA144793363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner