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General NPI Number Information
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NPI Number | 1548600430
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Entity Type | Individual
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Provider Name | ANTHONY JOSEPH DEDEA MD
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Gender | Male
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 4052 COMMERCIAL WAY
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City | SPRING HILL
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State | FL
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Zip | 34606-2398
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Country | US
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Telephone | 352-610-4812
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Fax | 352-556-4980
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Provider Business Mailing Address
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Address Line | PO BOX 5100
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City | SPRING HILL
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State | FL
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Zip | 34611-5100
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Country | US
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Telephone | 352-610-4812
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Fax | 352-556-4980
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 075777
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME137095
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License Number State | FL
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