Provider Demographics
NPI:1730158940
Name:HALPERIN, ANDREW J (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:HALPERIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 41543
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32203-1543
Mailing Address - Country:US
Mailing Address - Phone:904-376-4048
Mailing Address - Fax:904-225-8477
Practice Address - Street 1:463820 SR 200
Practice Address - Street 2:SUITE 103
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097
Practice Address - Country:US
Practice Address - Phone:904-225-2770
Practice Address - Fax:904-225-8477
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME62735207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251484200Medicaid
FL32529YMedicare PIN
FL32529ZMedicare PIN