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General NPI Number Information
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NPI Number | 1306207071
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Entity Type | Organization
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Legal Business Name | ANDERCARE INC
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Dates
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Enumeration Date | 03/09/2016
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Last Update Date | 03/09/2016
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Provider Practice Location Address
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Address Line | 8359 BEACON BLVD STE312
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City | FORT MYERS
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State | FL
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Zip | 33907-3048
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Country | US
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Telephone | 239-940-0614
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Fax |
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Provider Business Mailing Address
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Address Line | 16024 HERONS VIEW DR
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City | ALVA
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State | FL
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Zip | 33920
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Country | US
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Telephone | 239-425-5110
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. BRIAN D ANDERSON
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Credential |
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Telephone | 239-425-5110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299994294
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License Number State | FL
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