Provider Demographics
NPI:1245348291
Name:HAWRYCH, ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:HAWRYCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 770931
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34107-0931
Mailing Address - Country:US
Mailing Address - Phone:239-593-5000
Mailing Address - Fax:239-593-4902
Practice Address - Street 1:840 111TH AVE N
Practice Address - Street 2:SUITE 4
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1877
Practice Address - Country:US
Practice Address - Phone:239-593-5000
Practice Address - Fax:239-593-4902
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80588207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H21726Medicare UPIN
FL35590ZMedicare ID - Type Unspecified