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Individual

DR. AXEL WILLIAM ANDERSON IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2900 17TH ST, SUITE 2, SAINT CLOUD, FL 34769-6098
(407) 891-2951
(407) 891-2952
Mailing address
2900 17TH ST, SUITE 2, SAINT CLOUD, FL 34769-6098
(407) 891-2951
(407) 891-2952

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME43875
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
47682Z
MEDICARE
FL
01
G08749
UPIN
FL
Enumeration date
01/26/2007
Last updated
09/04/2013
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