Healthcare Provider Details

I. General information

NPI: 1285569822
Provider Name (Legal Business Name): BUNIQUE ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 SW 88TH ST
MIAMI FL
33156-7751
US

IV. Provider business mailing address

7440 SW 88TH ST
MIAMI FL
33156-7751
US

V. Phone/Fax

Practice location:
  • Phone: 601-622-2827
  • Fax:
Mailing address:
  • Phone: 601-622-2827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: