Provider Demographics
NPI:1548396260
Name:NELSON, ANDREW A (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:A
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 6TH ST S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4449
Mailing Address - Country:US
Mailing Address - Phone:727-895-8131
Mailing Address - Fax:727-821-1292
Practice Address - Street 1:350 6TH ST S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4449
Practice Address - Country:US
Practice Address - Phone:727-895-8131
Practice Address - Fax:727-821-1292
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA243746207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology