Basic Information
Provider Information
NPI: 1871723742
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHELL
FirstName: ANDREW
MiddleName: PHILIP
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6705 S RED RD
Address2: SUITE 704,706
City: SOUTH MIAMI
State: FL
PostalCode: 331433622
CountryCode: US
TelephoneNumber: 3056660203
FaxNumber: 7865331680
Practice Location
Address1: 6705 S RED RD
Address2: SUITE 704,706
City: SOUTH MIAMI
State: FL
PostalCode: 331433622
CountryCode: US
TelephoneNumber: 3056660203
FaxNumber: 7865331680
Other Information
ProviderEnumerationDate: 07/24/2009
LastUpdateDate: 10/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000XME118966FLY Allopathic & Osteopathic PhysiciansOtolaryngology 

ID Information
IDTypeStateIssuerDescription
01070800005FL MEDICAID


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