MEDICARE: CHRISTINE RENAUD ANDERSEN PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist
2	225100000X	Physical Therapist	02376	FL
3	174400000X	Specialist	02376	FL

General Provider Information

NPI Number	:	1255343091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE RENAUD ANDERSEN PT

Provider Business Mailing Address
First Line	:	1408 WYNNEWOOD DR
Second Line	:
City	:	WEST PALM BCH
State	:	FL
Zip	:	33417-5644
Country	:	US
Telephone Number	:	561-688-1796
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 S CONGRESS AVE
Second Line	:
City	:	WEST PALM BCH
State	:	FL
Zip	:	33409-3823
Country	:	US
Telephone Number	:	561-688-1796
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	03/31/2023

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Directions to “ CHRISTINE RENAUD ANDERSEN PT” Practice Location

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