Provider Demographics
NPI:1972752426
Name:ANDRADE, EDWARD FRANCIS JR (MA)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:FRANCIS
Last Name:ANDRADE
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2557 ROBERTA ST
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-1235
Mailing Address - Country:US
Mailing Address - Phone:727-519-9423
Mailing Address - Fax:
Practice Address - Street 1:2188 58TH ST N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3112
Practice Address - Country:US
Practice Address - Phone:727-489-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH6467101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health