Basic Information
| Provider Information | |||||||||
| NPI: | 1003814922 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZWICK | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5431 N. UNIVERSITY DRIVE | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330674639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543442522 | ||||||||
| FaxNumber: | 9543449189 | ||||||||
| Practice Location | |||||||||
| Address1: | 9970 CENTRAL PARK BLVD. | ||||||||
| Address2: | STE. 101 | ||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334282237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613952424 | ||||||||
| FaxNumber: | 5613952709 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2005 | ||||||||
| LastUpdateDate: | 10/10/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | ME0065365 | FL | N | Other Service Providers | Specialist | 207RG0100X | ME65365 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | ME0065365 | 01 | FL | LICENSE NUMBER | OTHER | 2983677007 | 01 | FL | CIGNA PROVIDER NUMBER | OTHER | 28433 | 01 | FL | HEALTH OPTIONS PROVIDER # | OTHER | 5521288 | 01 | FL | AETNA PROVIDER # | OTHER |