Provider Demographics
NPI:1851402986
Name:ANDREW M. SCANAMEO
Entity Type:Organization
Organization Name:ANDREW M. SCANAMEO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:SCANAMEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-510-1183
Mailing Address - Street 1:P.O. BOX 16128
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317
Mailing Address - Country:US
Mailing Address - Phone:850-325-4900
Mailing Address - Fax:850-325-7080
Practice Address - Street 1:2565 CAPITAL MEDICAL BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-906-9369
Practice Address - Fax:850-999-6563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0072947207QA0505X, 207RG0300X, 207RG0300X
207RG0300X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264319700Medicaid
FLK3385Medicare PIN