Provider Demographics
NPI:1487328209
Name:KAPADIA, ANDREW DANIEL
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:DANIEL
Last Name:KAPADIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11225 SECRET WOODS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-1160
Mailing Address - Country:US
Mailing Address - Phone:954-536-3806
Mailing Address - Fax:
Practice Address - Street 1:10950 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5208
Practice Address - Country:US
Practice Address - Phone:954-566-4551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCRT83098156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist