Healthcare Provider Details

I. General information

NPI: 1396298030
Provider Name (Legal Business Name): CURTIS L ANDERSON MD PHD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2016
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7556 LAKE WORTH RD STE 103
LAKE WORTH FL
33467-2503
US

IV. Provider business mailing address

7556 LAKE WORTH RD STE 103
LAKE WORTH FL
33467-2503
US

V. Phone/Fax

Practice location:
  • Phone: 561-894-1370
  • Fax: 561-894-1372
Mailing address:
  • Phone: 561-894-1370
  • Fax: 561-894-1372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME114142
License Number StateFL

VIII. Authorized Official

Name: CURTIS L ANDERSON
Title or Position: PRESIDENT/OWNER
Credential: MD, PHD
Phone: 561-870-4628