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NPI Code Detail

MEDICARE: PATRICIA J ANDERSON MD LLC

MEDICARE: PATRICIA J ANDERSON MD LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology PhysicianME82277FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME82277OTHERFLSTATE OF FLORIDA LICENSE
258820OTHERFLBCBS FLORIDA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134363120
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATRICIA J ANDERSON MD LLC
Provider Business Mailing Address
First Line : PO BOX 915
Second Line :
City : PANAMA CITY
State : FL
Zip : 32402-0915
Country : US
Telephone Number : 850-914-8600
Fax Number : 850-784-7706
Provider Business Practice Location Address
First Line : 1847 FLORIDA AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4640
Country : US
Telephone Number : 850-914-8600
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. PATRICIA J ANDERSON
Credential : M.D.
Telephone Number : 850-914-8600
Provider Enumeration Date : 04/22/2009
Last Update Date : 04/22/2009

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