Provider Demographics
NPI:1063073906
Name:LELCHUK, ANDREW (DO)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:LELCHUK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 CLINT MOORE RD STE 115
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-5712
Mailing Address - Country:US
Mailing Address - Phone:561-997-8484
Mailing Address - Fax:561-997-8429
Practice Address - Street 1:1601 CLINT MOORE RD STE 115
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-5712
Practice Address - Country:US
Practice Address - Phone:561-997-8484
Practice Address - Fax:561-997-8429
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11636300208D00000X
FLOS20179208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist