Active NPI
Andrea Maria Petrucci, M.D.C.M.
- Colon & Rectal Surgery Physician
- Weston, FL
National Provider Identifier
1790169399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- 21010
- Practice address
- 2950 Cleveland Clinic Blvd
Weston, FL 33331-3609 - Phone
- (954) 659-5000
- NPI assigned
- Jul 13, 2015
- Last updated
- Jul 13, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Colon & Rectal Surgery Physician | 208C00000X | 21010 | FL | Primary |
Addresses
Primary practice location
2950 Cleveland Clinic Blvd
Weston, FL 33331-3609
Mailing address
2950 Cleveland Clinic Blvd
Weston, FL 33331-3609
Phone (954) 659-5000
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21010 | FL | MD | Colon & Rectal Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1790169399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2950 CLEVELAND CLINIC BLVD",
"city": "WESTON",
"state": "FL",
"postal_code": "333313609",
"telephone_number": "954-659-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2950 CLEVELAND CLINIC BLVD",
"city": "WESTON",
"state": "FL",
"postal_code": "333313609",
"telephone_number": "954-659-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRUCCI",
"first_name": "ANDREA",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "M.D.C.M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-13",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "FL",
"license": "21010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.