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NPI Code Detail

MEDICARE: ROBERT ANDERSON PLLC

MEDICARE: ROBERT ANDERSON PLLC
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
1207Q00000XFamily Medicine PhysicianOS6082FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
180525OTHERFLBLUE CROSS

General Provider Information

NPI Number : 1932281367
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERT ANDERSON PLLC
Provider Business Mailing Address
First Line : PO BOX 12957
Second Line :
City : FORT PIERCE
State : FL
Zip : 34979-2957
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 778 W MIDWAY RD
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-4203
Country : US
Telephone Number : 772-429-0692
Fax Number : 772-429-0592
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : ROBERT V ANDERSON
Credential : D.O.
Telephone Number : 772-429-0692
Provider Enumeration Date : 10/19/2006
Last Update Date : 08/22/2020

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