Provider Demographics
NPI:1366434607
Name:DADRAT, ANDREE A (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREE
Middle Name:A
Last Name:DADRAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7152 COCA SABAL LN
Mailing Address - Street 2:
Mailing Address - City:FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4263
Mailing Address - Country:US
Mailing Address - Phone:239-939-9939
Mailing Address - Fax:239-931-5060
Practice Address - Street 1:7152 COCA SABAL LN
Practice Address - Street 2:
Practice Address - City:FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4263
Practice Address - Country:US
Practice Address - Phone:239-939-9939
Practice Address - Fax:239-931-5060
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066469207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375469300Medicaid
FL25379OtherBLUE CROSS BLUE SHIELD
FL375469300Medicaid
FLE93004Medicare UPIN
FL25379WMedicare PIN