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General NPI Number Information
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NPI Number | 1356300669
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Entity Type | Individual
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Provider Name | TORSTEN WAINO ANDERSEN MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 149 NE 241ST ST DIXIE COUNTY HEALTH DEPARTMENT
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City | CROSS CITY
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State | FL
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Zip | 32628-5844
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Country | US
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Telephone | 352-498-1360
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Fax | 352-498-1363
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Provider Business Mailing Address
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Address Line | 149 NE 241ST ST
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City | CROSS CITY
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State | FL
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Zip | 32628-5844
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Country | US
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Telephone | 352-498-1360
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Fax | 352-498-1363
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME21596
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License Number State | FL
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