Individual
EMILY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7000 H C KELLEY RD, ORLANDO, FL 32831-2521
(703) 408-9293
Mailing address
1329 SW 16TH ST RM 2232, GAINESVILLE, FL 32608-1128
(352) 559-5051
(352) 265-8018
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9113861
FL
363AM0700X
Medical Physician Assistant
9113861
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9113861
PHYSICIAN ASSISTANT LICENSE
FL
Enumeration date
07/20/2021
Last updated
07/10/2024
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