Provider Demographics
NPI:1518181668
Name:POGIATZIS, ANDREW D (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:POGIATZIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8599 SW HIGHWAY 200
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-7729
Mailing Address - Country:US
Mailing Address - Phone:352-861-0043
Mailing Address - Fax:352-861-8750
Practice Address - Street 1:8599 SW HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-7729
Practice Address - Country:US
Practice Address - Phone:352-861-0043
Practice Address - Fax:352-861-8750
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME121940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY139326OtherSTATE LICENSE
FLME121940OtherLICENSE
FLME121940OtherLICENSE
HZ823ZMedicare UPIN