Provider Demographics
NPI:1841694684
Name:HUGGINS, ANDRE
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:
Last Name:HUGGINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3847 TURTLE RUN BLVD
Mailing Address - Street 2:APT 2423
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4228
Mailing Address - Country:US
Mailing Address - Phone:619-433-4110
Mailing Address - Fax:
Practice Address - Street 1:1687 POCAHONTAS ST
Practice Address - Street 2:BLDG 1A
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23511-2918
Practice Address - Country:US
Practice Address - Phone:757-445-7251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman