Healthcare Provider Details

I. General information

NPI: 1912955139
Provider Name (Legal Business Name): NORMAN H. ANDERSON, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
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: 352-732-6574
Mailing address:
  • Phone: 352-861-0440
  • Fax: 352-861-1869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: NORMAN H ANDERSON
Title or Position: PRESIDENT, CEO
Credential: MD
Phone: 352-732-0277