Provider Demographics
NPI:1144477795
Name:ANDREOIU, MATEI T (MD)
Entity type:Individual
Prefix:
First Name:MATEI
Middle Name:T
Last Name:ANDREOIU
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 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-434-9528
Mailing Address - Fax:321-951-7408
Practice Address - Street 1:1846 HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2822
Practice Address - Country:US
Practice Address - Phone:321-434-9528
Practice Address - Fax:321-434-9529
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME10755208800000X, 208800000X
ARE-8244208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102487900Medicaid
FLKP392OtherMEDICARE