Provider Demographics
NPI:1265872683
Name:THOMPSON, ANDREW ANTHONY (RDMS,MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ANTHONY
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:RDMS,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 S KIRKMAN RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-2833
Mailing Address - Country:US
Mailing Address - Phone:407-692-8737
Mailing Address - Fax:
Practice Address - Street 1:5600 W COLONIAL DR
Practice Address - Street 2:SUITE 312
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7646
Practice Address - Country:US
Practice Address - Phone:407-692-8737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-29
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL249462471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography