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DR. LUIS M ANDERSON M.D.

>> Pediatrics >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1649337635

Individual Registrant:
DR. LUIS M ANDERSON M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
3670 US 1 S STE 300B  SAINT AUGUSTINE, FL 32086-6354 US
Tel: 904-479-9501  Fax: 904-217-0524

Contact information for business:
3670 US 1 S STE 300B  SAINT AUGUSTINE, FL 32086-6354 US
Tel: 904-479-9501  Fax: 904-217-0524

Registration Information:
NPI: 1649337635
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y208000000XAllopathic & Osteopathic Physicians
Pediatrics
FLME0089595

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
269304600FL05
AETNA7201378FL01
TAX ID650598984FL01
BCBS37560FL01




HEALTH CARE JOBS FL - Page 1



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