Provider Demographics
NPI:1447434873
Name:ANDRE F.A. JAWDE, MD, PA
Entity type:Organization
Organization Name:ANDRE F.A. JAWDE, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:FA
Authorized Official - Last Name:JAWDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-942-2337
Mailing Address - Street 1:1449 MICCOSUKEE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5171
Mailing Address - Country:US
Mailing Address - Phone:850-942-2337
Mailing Address - Fax:850-942-2843
Practice Address - Street 1:1449 MICCOSUKEE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5171
Practice Address - Country:US
Practice Address - Phone:850-942-2337
Practice Address - Fax:850-942-2843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME29007174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty