Provider Demographics
NPI:1619906955
Name:HASS, ANDREA N (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:N
Last Name:HASS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2165 RADNOR RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2149
Mailing Address - Country:US
Mailing Address - Phone:561-626-9915
Mailing Address - Fax:
Practice Address - Street 1:2401 PGA BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3590
Practice Address - Country:US
Practice Address - Phone:561-624-7777
Practice Address - Fax:561-624-9995
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069121207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28186Medicare ID - Type Unspecified
FLF15148Medicare UPIN