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Individual

ANDREA R KUIPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
8960 COLONIAL CENTER DR STE 302, FORT MYERS, FL 33905-7810
(239) 343-9700
(239) 343-9699
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9700
(239) 343-9699

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103589
FL
363AS0400X
Surgical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000621200
FL
01
P01272555
RAILROAD MCR
FL
01
Y04JJ
BCBS OF FL
FL
Enumeration date
07/07/2006
Last updated
03/29/2021
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