Individual
DR. EDGAR LEOPOLD ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1690 DUNLAWTON AVE STE 125, PORT ORANGE, FL 32127-8980
(386) 793-5743
(386) 246-3661
Mailing address
1690 DUNLAWTON AVE, SUITE 125, PORT ORANGE, FL 32127-8979
(386) 246-3661
(386) 246-3661
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 9229694
FL
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
RN 9229694
FL
Other
Enumeration date
11/08/2012
Last updated
11/10/2012
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