Provider Demographics
NPI:1851569610
Name:WASSERMAN, ANDREW S (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:S
Last Name:WASSERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10394 W SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3970
Mailing Address - Country:US
Mailing Address - Phone:954-755-1980
Mailing Address - Fax:954-755-1994
Practice Address - Street 1:10394 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3970
Practice Address - Country:US
Practice Address - Phone:954-755-1980
Practice Address - Fax:954-755-1994
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT94413Medicare UPIN