Individual
DR. JON E. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 E DIXIE AVE, SUITE 104, LEESBURG, FL 34748-7600
(352) 365-2583
(352) 728-6749
Mailing address
2801 ATLANTIC AVE, LONG BEACH, CA 90806
(562) 933-1550
(562) 933-8088
Taxonomy
Speciality
Code
Description
License number
State
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
ME75253
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME75253
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260572400
—
FL
01
—
300116799
RR MDCR LMIV
FL
01
—
300116800
RR MEDICARE RACF
FL
Enumeration date
05/04/2006
Last updated
01/21/2026
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