Healthcare Provider Details

I. General information

NPI: 1346772837
Provider Name (Legal Business Name): ZACHARY ANDERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONROE CARELL JR CHILDRENS HOSPITAL AT 2200 CHILDREN'S WAY 8161 DOT
NASHVILLE TN
37232-9760
US

IV. Provider business mailing address

1870 CAROLLEE LN
WINTER PARK FL
32789-5214
US

V. Phone/Fax

Practice location:
  • Phone: 615-936-2555
  • Fax: 615-936-3601
Mailing address:
  • Phone: 321-279-7012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME163038
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME163038
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: