Healthcare Provider Details

I. General information

NPI: 1831884410
Provider Name (Legal Business Name): ANCHORED MED SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/10/2023
Certification Date: 04/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SE OCEAN BLVD
STUART FL
34994-2214
US

IV. Provider business mailing address

1 SE OCEAN BLVD
STUART FL
34994-2214
US

V. Phone/Fax

Practice location:
  • Phone: 772-877-9676
  • Fax: 772-492-4886
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. JUSTIN DOWD
Title or Position: APRN
Credential: APRN
Phone: 386-872-2484