Individual
DR. ANDREW L RUTHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16404 SWAN VIEW CIR, ODESSA, FL 33556-4938
(813) 753-7340
Mailing address
16404 SWAN VIEW CIR, ODESSA, FL 33556-4938
(813) 753-7340
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME98900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000675900
—
FL
01
—
17495
BCBS
FL
01
—
ME98900
MEDICAL LICENSE
FL
Enumeration date
08/29/2007
Last updated
11/30/2018
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