Provider Demographics
NPI:1508885872
Name:BARTELL, ANDREW K (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:K
Last Name:BARTELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8825 PERIMETER PARK BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1108
Mailing Address - Country:US
Mailing Address - Phone:904-236-5023
Mailing Address - Fax:904-236-5073
Practice Address - Street 1:8825 PERIMETER PARK BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1108
Practice Address - Country:US
Practice Address - Phone:904-236-5023
Practice Address - Fax:904-226-5073
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3147213E00000X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL50393OtherBLUE CROSS BLUE SHIELD
FL99763OtherBCBS GROUP
FL340474900Medicaid
FLP00407506Medicare PIN
FLV01111Medicare UPIN
FLU3054YMedicare PIN
FL99763OtherBCBS GROUP