Provider Demographics
NPI:1851569701
Name:ABREU, ANDRES (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:
Last Name:ABREU
Suffix:
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 1:2415 UNIVERSITY PKWY
Mailing Address - Street 2:SUITE 112 BLD 3
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2809
Mailing Address - Country:US
Mailing Address - Phone:941-355-9800
Mailing Address - Fax:941-355-9811
Practice Address - Street 1:2415 UNIVERSITY PKWY
Practice Address - Street 2:SUITE 112 BLD 3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2809
Practice Address - Country:US
Practice Address - Phone:941-355-9800
Practice Address - Fax:941-355-9811
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010158592085R0202X
FLOS106112085R0202X
FLOS 10611208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01412831OtherRR MEDICARE
FLOS10611OtherLICENSE NO
FL008464800Medicaid
FLCI888TMedicare PIN