Provider Demographics
NPI:1356389738
Name:DOBRADIN, ANDREW (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:DOBRADIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANDRZEJ
Other - Middle Name:
Other - Last Name:DOBRADIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:320 EDINBURGH DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4157
Mailing Address - Country:US
Mailing Address - Phone:407-647-3460
Mailing Address - Fax:407-647-3484
Practice Address - Street 1:320 EDINBURGH DR
Practice Address - Street 2:SUITE B
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4157
Practice Address - Country:US
Practice Address - Phone:407-647-3460
Practice Address - Fax:407-647-3484
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64665208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00039735OtherRAILROAD MEDICARE
FL23035OtherBCBS
FL23035OtherBCBS
P00039735OtherRAILROAD MEDICARE