Healthcare Provider Details

I. General information

NPI: 1609824432
Provider Name (Legal Business Name): NORMAN H ANDERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 SE 17TH ST
OCALA FL
34471-4118
US

IV. Provider business mailing address

2020 SE 17TH ST
OCALA FL
34471-4118
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-0277
  • Fax: 352-861-1869
Mailing address:
  • Phone: 352-732-0277
  • Fax: 352-414-5088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberME42553
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: