MEDICARE: TROY 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	335E00000X	Prosthetic/Orthotic Supplier	ORT267	FL

General Provider Information

NPI Number	:	1538544846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY ANDERSON

Provider Business Mailing Address
First Line	:	2606 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2218
Country	:	US
Telephone Number	:	863-937-9200
Fax Number	:	863-937-9199

Provider Business Practice Location Address
First Line	:	2606 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2218
Country	:	US
Telephone Number	:	863-937-9200
Fax Number	:	863-937-9199

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

Provider Enumeration Date	:	07/28/2015
Last Update Date	:	07/28/2015

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Directions to “ TROY ANDERSON ” Practice Location

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