Provider Demographics
NPI:1104907328
Name:ANDREWS INSTITUTE ASC LLC
Entity type:Organization
Organization Name:ANDREWS INSTITUTE ASC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF BOARD OF MANAGERS
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:STORY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-469-2338
Mailing Address - Street 1:1040 GULF BREEZE PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561
Mailing Address - Country:US
Mailing Address - Phone:850-916-8500
Mailing Address - Fax:850-916-8509
Practice Address - Street 1:1040 GULF BREEZE PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561
Practice Address - Country:US
Practice Address - Phone:850-916-8500
Practice Address - Fax:850-916-8509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical