Individual
DR. ANDRE HEBRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22655 BAYSHORE RD STE 110, PORT CHARLOTTE, FL 33980-2005
(941) 235-4900
(941) 235-4901
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6050
(239) 343-9909
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
13964
SC
2086S0120X
Pediatric Surgery Physician
Primary
ME83890
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019156800
—
FL
05
—
263327200
—
FL
Enumeration date
05/06/2006
Last updated
06/27/2024
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