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Individual

ANAIS ANDARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
13535 NEMOURS PKWY, ORLANDO, FL 32827-7402
(407) 650-7622
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532

Taxonomy

Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
PA9110650
FL
363A00000X
Physician Assistant
Primary
PA9110650
FL

Other

Enumeration date
10/16/2017
Last updated
10/16/2017
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