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General NPI Number Information
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NPI Number | 1497914105
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Entity Type | Organization
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Legal Business Name | KATHY L ANDERSON DO PA
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Dates
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Enumeration Date | 06/06/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 510 DRUID RD E SUITE A
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City | CLEARWATER
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State | FL
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Zip | 33756-3950
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Country | US
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Telephone | 727-462-5242
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Fax |
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Provider Business Mailing Address
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Address Line | 510 DRUID RD E SUITE A
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City | CLEARWATER
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State | FL
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Zip | 33756-3950
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Country | US
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Telephone | 727-462-5242
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KATHY L ANDERSON
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Credential |
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Telephone | 717-462-5242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OS7994
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License Number State | FL
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