Provider Demographics
NPI:1972700276
Name:TOMAC, ANDREAS C (MD, PHD, FAANS)
Entity Type:Individual
Prefix:DR
First Name:ANDREAS
Middle Name:C
Last Name:TOMAC
Suffix:
Gender:M
Credentials:MD, PHD, FAANS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 W 49TH PL STE 402
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3147
Mailing Address - Country:US
Mailing Address - Phone:954-633-7858
Mailing Address - Fax:866-611-2922
Practice Address - Street 1:1435 W 49TH PL STE 402
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3147
Practice Address - Country:US
Practice Address - Phone:954-633-7858
Practice Address - Fax:866-611-2922
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114492207T00000X, 207T00000X
OH35.098872207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0111936Medicaid
OH0111936Medicaid