Provider Demographics
NPI:1295927739
Name:KATZ, ANDREA (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:ROSENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:392-748-2002
Mailing Address - Fax:
Practice Address - Street 1:401 PALMETTO ST
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-7322
Practice Address - Country:US
Practice Address - Phone:386-424-5038
Practice Address - Fax:386-424-5081
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113573207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9420727OtherAETNA KEY WEST
FLP1052209OtherFREEDOM JUPITER
FL14LR5OtherBCBS
FL9420727OtherAETNA
FLGN848VOtherMEDICARE - KEY WEST
FLP984360OtherOPTIMUM JUPITER
FLGN848WOtherMEDICARE - JUPITER