Individual
ANTHONY ALAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 BLUFF LAKE RD, MASCOTTE, FL 34753-9536
(352) 460-6093
(352) 366-0230
Mailing address
15508 WILLET CT, MASCOTTE, FL 34753-9102
(523) 460-6093
(352) 366-0230
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
022905700
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022905700
—
FL
Enumeration date
04/09/2019
Last updated
04/09/2019
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