Healthcare Provider Details

I. General information

NPI: 1285623686
Provider Name (Legal Business Name): A SCOTT ANDERSON PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALVA SCOTT ANDERSON PHARM. D.

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

3609 NW 136TH ST
GAINESVILLE FL
32606-4737
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-1611
  • Fax:
Mailing address:
  • Phone: 352-376-1611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number25399
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: