Provider Demographics
NPI:1609448786
Name:ANDRE, JAMES (NP-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:ANDRE
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 METROPOLIS WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-2706
Mailing Address - Country:US
Mailing Address - Phone:321-344-1273
Mailing Address - Fax:
Practice Address - Street 1:5920 METROPOLIS WAY STE 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-2706
Practice Address - Country:US
Practice Address - Phone:321-344-1273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11013771363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology