Provider Demographics
NPI:1548573843
Name:ANDAL, LAURIE MAY NANEZ (DO)
Entity Type:Individual
Prefix:
First Name:LAURIE MAY
Middle Name:NANEZ
Last Name:ANDAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 WORTH CT
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-2110
Mailing Address - Country:US
Mailing Address - Phone:941-251-4031
Mailing Address - Fax:941-251-4034
Practice Address - Street 1:1935 WORTH CT
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-2110
Practice Address - Country:US
Practice Address - Phone:941-251-4031
Practice Address - Fax:941-251-4034
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA013828207R00000X
FLOS13321207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine