Healthcare Provider Details

I. General information

NPI: 1871743815
Provider Name (Legal Business Name): MICHAEL ROBERT ANDERSON JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16006 KEALAN CIR
MONTVERDE FL
34756-4001
US

IV. Provider business mailing address

16006 KEALAN CIR
MONTVERDE FL
34756-4001
US

V. Phone/Fax

Practice location:
  • Phone: 352-881-2446
  • Fax:
Mailing address:
  • Phone: 352-881-2446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH13890
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: