Individual provider Active NPI

Andrea Andrade, LDN, RD

  • Registered Dietitian
  • Port Charlotte, FL
National Provider Identifier
1558258228
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND9010 Issued in FL
Practice address
24151 Beatrix Blvd Unit 905
Port Charlotte, FL 33954-3852
Phone
(321) 402-8735
NPI assigned
Jun 23, 2025
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND9010 FL Primary

Addresses

Primary practice location

24151 Beatrix Blvd Unit 905
Port Charlotte, FL 33954-3852

Mailing address

24151 Beatrix Blvd Unit 905
Port Charlotte, FL 33954-3852
Phone (321) 402-8735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ND9010FLMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1558258228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24151 BEATRIX BLVD UNIT 905",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339543852",
            "telephone_number": "321-402-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24151 BEATRIX BLVD UNIT 905",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339543852",
            "telephone_number": "321-402-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "ANDREA",
        "credential": "LDN, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND9010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.