Individual
MS. ANDREA A MCINTOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2575 S VOLUSIA AVE, SUITE 300, ORANGE CITY, FL 32763-9135
(386) 774-0401
Mailing address
2555S VOLUSIA AVE, ORANGE CITY, FL 32763-9116
(386) 774-0401
(386) 774-5783
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9102239
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291511100
—
FL
Enumeration date
09/02/2006
Last updated
09/19/2015
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