Individual
CHARLES R ANDERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
700 W OAK ST, KISSIMMEE, FL 34741-4924
(407) 846-2266
Mailing address
2938 ROLLING BROAK DR, ORLANDO, FL 32837-7469
(407) 857-3161
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP2776592
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304980900
—
FL
01
—
430077443
MEDICARE RAILROAD
—
01
—
G1754
BLUE CROSS
FL
Enumeration date
05/31/2006
Last updated
06/23/2008
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