Provider Demographics
NPI:1912939208
Name:NULLMAN, ANDREW E (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:E
Last Name:NULLMAN
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 1:1190 NW 95TH ST STE 412
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-2067
Mailing Address - Country:US
Mailing Address - Phone:305-534-4404
Mailing Address - Fax:305-691-4449
Practice Address - Street 1:1190 NW 95TH ST STE 412
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2067
Practice Address - Country:US
Practice Address - Phone:305-534-4404
Practice Address - Fax:305-691-4449
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51981207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053552400Medicaid
FL08230AMedicare ID - Type UnspecifiedMEDICARE
FL053552400Medicaid
FL08230Medicare ID - Type UnspecifiedMEDICARE
FL08230BMedicare ID - Type UnspecifiedMEDICARE