MEDICARE: PATRICK ANDERSON

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	101YM0800X	Mental Health Counselor	MH26860	FL

General Provider Information

NPI Number	:	1427839273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK ANDERSON

Provider Business Mailing Address
First Line	:	8805 DEEP MAPLE DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33578-8982
Country	:	US
Telephone Number	:	813-539-7535
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 S PINELLAS AVE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-1955
Country	:	US
Telephone Number	:	727-547-3692
Fax Number	:

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

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	05/19/2026

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