Provider Demographics
NPI:1528586203
Name:RASMUSSEN, ANDREW DANIEL
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:DANIEL
Last Name:RASMUSSEN
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 1:1310 WESTOVER AVE
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-2799
Mailing Address - Country:US
Mailing Address - Phone:941-524-5911
Mailing Address - Fax:
Practice Address - Street 1:1310 WESTOVER AVE
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-2799
Practice Address - Country:US
Practice Address - Phone:941-524-5911
Practice Address - Fax:941-524-5911
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-01
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician