Individual
DR. ANDY BRUCE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
613 RED FERN RD, CRESTVIEW, FL 32536-5472
(407) 733-2037
Mailing address
613 RED FERN RD, CRESTVIEW, FL 32536-5472
(407) 733-2037
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS10740
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001537700
—
FL
01
—
CT570Z
MEDICARE PTAN
FL
Enumeration date
08/03/2009
Last updated
10/17/2013
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