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General NPI Number Information
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NPI Number | 1881538403
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Entity Type | Organization
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Legal Business Name | ANDERSON PRIMARY CARE PLLC
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 7800 66TH ST N STE 206
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2101
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Country | US
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Telephone | 727-300-0063
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Fax | 727-256-0039
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Provider Business Mailing Address
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Address Line | 7800 66TH ST N STE 206
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2101
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Country | US
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Telephone | 727-300-0063
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Fax | 727-256-0039
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | RONALD D DAYTON
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Credential |
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Telephone | 727-900-1326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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