Individual
MRS. ANDREA M PERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(850) 862-1111
Mailing address
19801 OBSERVATION DR, GERMANTOWN, MD 20876-4070
(301) 557-6000
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA9105278
FL
363A00000X
Physician Assistant
Primary
C07180
MD
363AM0700X
Medical Physician Assistant
PA458
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292457900
—
FL
Enumeration date
07/05/2006
Last updated
08/06/2019
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