Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | OS16438 | FL |
N | 207YS0123X | Facial Plastic Surgeon | OT016549 | PA |
NPI | 1770964488 |
---|---|
Provider Name | Dr. Andrew William Agnew |
First Address | Tampa, FL 33613-6601 |
Second Address | Tampa, FL 33613-6601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2015 |
Last Update Date | 17/08/2021 |