Provider Demographics
NPI:1679503650
Name:RESS, ANDREW MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:MICHAEL
Last Name:RESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6877 SW 18TH ST
Mailing Address - Street 2:SUITE H201
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-7046
Mailing Address - Country:US
Mailing Address - Phone:561-347-1611
Mailing Address - Fax:561-347-1455
Practice Address - Street 1:6877 SW 18TH ST
Practice Address - Street 2:SUITE H201
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7046
Practice Address - Country:US
Practice Address - Phone:561-347-1611
Practice Address - Fax:561-347-1455
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL0073232208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF44658Medicare UPIN