Individual
DR. ANDREW LEE RAIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
13681 DOCTORS WAY, GULF COAST MEDICAL CENTER, FORT MYERS, FL 33912-3391
(239) 343-1000
Mailing address
2332 SAINT DAVID ISLAND CT, PUNTA GORDA, FL 33950-8146
(941) 639-7743
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS8882
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267425400
—
FL
01
—
71114
BLUECROSS
FL
Enumeration date
04/03/2006
Last updated
01/13/2023
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