Healthcare Provider Details

I. General information

NPI: 1225098205
Provider Name (Legal Business Name): SCOTT ROBERT ANDERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10461 QUALITY DR
SPRING HILL FL
34609-9634
US

IV. Provider business mailing address

2330 UTAH AVE STE 200
EL SEGUNDO CA
90245-4817
US

V. Phone/Fax

Practice location:
  • Phone: 352-754-3246
  • Fax: 323-797-9519
Mailing address:
  • Phone: 813-251-5822
  • Fax: 813-254-4597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME74273
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: