Individual
MICHAEL ANGELO ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT-P
Contact information
Practice address
618 SCENIC ST, LEESBURG, FL 34748-6226
(352) 303-6143
(352) 728-3719
Mailing address
618 SCENIC ST, LEESBURG, FL 34748-6226
(352) 303-6143
(352) 728-3719
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PMD510306
FL
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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