Provider Demographics
NPI:1932523925
Name:MCGLONE, ANDREA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:MCGLONE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2700 W CYPRESS CREEK RD
Mailing Address - Street 2:SUITE C100
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1744
Mailing Address - Country:US
Mailing Address - Phone:954-974-3111
Mailing Address - Fax:954-974-6191
Practice Address - Street 1:2700 W CYPRESS CREEK RD
Practice Address - Street 2:SUITE C100
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1744
Practice Address - Country:US
Practice Address - Phone:954-974-3111
Practice Address - Fax:954-974-6191
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9107716363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical