Provider Demographics
NPI:1770825846
Name:MUNDY, ANDREW CARROLL (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CARROLL
Last Name:MUNDY
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 1:2661 BUTTERFLY JASMINE TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-1229
Mailing Address - Country:US
Mailing Address - Phone:423-584-1539
Mailing Address - Fax:
Practice Address - Street 1:3277 FRUITVILLE RD STE 2
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6410
Practice Address - Country:US
Practice Address - Phone:941-500-2736
Practice Address - Fax:941-500-2736
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.125456207X00000X
FLME149789207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery