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NPI Code Detail

MEDICARE: MR. KEVIN PATRICK ANDERSON M.P.T., CSCS

MEDICARE: MR. KEVIN PATRICK ANDERSON M.P.T., CSCS
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
12251X0800XOrthopedic Physical TherapistPT18060FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902920523
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEVIN PATRICK ANDERSON M.P.T., CSCS
Provider Business Mailing Address
First Line : 770 HUNTINGTON PINES DR
Second Line :
City : OCOEE
State : FL
Zip : 34761-3368
Country : US
Telephone Number : 321-277-9314
Fax Number :
Provider Business Practice Location Address
First Line : 1155 S ORLANDO AVE
Second Line :
City : WINTER PARK
State : FL
Zip : 32789-4852
Country : US
Telephone Number : 321-277-9314
Fax Number : 407-628-2572
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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