Provider Demographics
NPI:1790888964
Name:SCIARRINO, ANDREW (DPM)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:SCIARRINO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:ANDREW
Other - Middle Name:
Other - Last Name:SCIARRINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:PO BOX 5246
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277
Mailing Address - Country:US
Mailing Address - Phone:941-312-4751
Mailing Address - Fax:941-312-4751
Practice Address - Street 1:8407 IDLEWOOD CT
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202
Practice Address - Country:US
Practice Address - Phone:941-312-4751
Practice Address - Fax:941-312-4751
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0001961213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA584418OtherBCBS PA
FL65092OtherBCBS
PA584418OtherBCBS PA
FL65092Medicare ID - Type Unspecified