Provider Demographics
NPI:1760967517
Name:SAFRON, ANDREW III (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:SAFRON
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5239 STARFISH AVE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2464
Mailing Address - Country:US
Mailing Address - Phone:239-248-1535
Mailing Address - Fax:
Practice Address - Street 1:5239 STARFISH AVE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2464
Practice Address - Country:US
Practice Address - Phone:239-248-1535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS69312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS6931OtherDO LICENSE NUMBER