Individual
DR. ANDREW GLEN MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1286 FLORIDA AVE S, ROCKLEDGE, FL 32955-2484
(321) 636-7780
Mailing address
1272 VESTAVIA CIR, MELBOURNE, FL 32940-2301
(786) 877-2831
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
35.122891
OH
207N00000X
Dermatology Physician
Primary
ME118731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HT739Z
MEDICARE PTAN
FL
Enumeration date
04/03/2009
Last updated
06/30/2014
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