Healthcare Provider Details

I. General information

NPI: 1700266871
Provider Name (Legal Business Name): LAUREN ALTMAN ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN DANIELLE ALTMAN

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3491 GANDY PARK SUITE 100
PINELLAS PARK FL
33781
US

IV. Provider business mailing address

1319 12TH AVE S
SAINT PETERSBURG FL
33705-2307
US

V. Phone/Fax

Practice location:
  • Phone: 727-390-2211
  • Fax: 317-520-8200
Mailing address:
  • Phone: 727-320-6479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0156439
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: