Andrew J. Hanzlik, M.D., P.a.

Key facts

NPI

1124378229

Entity type

Organization (NPI type 2)

Primary specialty

Ophthalmology Physician 207W00000X

License

ME73735 (FL)

Legal business name

ANDREW J. HANZLIK, M.D., P.A.

Practice address

2215 North Blvd W
Davenport, FL 33837-8990

Phone

(863) 421-9898

NPI assigned

Sep 15, 2012

Organization subpart

No

Authorized official

Name

Dr. Andrew Janusz Hanzlik NPI 1588736474

Title

President

Phone

(863) 421-9898

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew J Hanzlik, MD PA Ophthalmology Physician · Davenport, FL · NPI 1588736474
  Medicare reassignment NPD Authorized official FL · OPHTHALMOLOGY
• Anamaria Puerta Santiago, O.D. Optometrist · Orlando, FL · NPI 1932372760
  Medicare reassignment NPD FL

Medicare participation

Medicare fee-for-service enrollment

Enrolled in FL

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 15, 2012.

{
    "created_epoch": "1347667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347667200000",
    "number": "1124378229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NORTH BLVD W",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338378990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 NORTH BLVD W",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338378990",
            "telephone_number": "863-421-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW J. HANZLIK, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-15",
        "last_updated": "2012-09-15",
        "status": "A",
        "authorized_official_last_name": "HANZLIK",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JANUSZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-421-9898",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME73735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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