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MILES C ANDERSON MD
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1164403689
Individual Registrant: MILES C ANDERSON MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
21 HOSPITAL DR STE 125 PALM COAST, FL 32164-2455 US
Tel: 386-586-7005 Fax: 844-867-3940
Tel: 386-586-7005 Fax: 844-867-3940
Contact information for business:
6101 BLUE LAGOON DR STE 400 MIAMI, FL 33126-2051 US
Tel: 305-500-2000 Fax: --
Tel: 305-500-2000 Fax: --
Registration Information:
NPI: 1164403689
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | FL | ME81063 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| BLUE CROSS/BLUE SHIELD | 35931 | FL | 01 |
| 259553200 | FL | 05 | |
| RAILROAD MEDICARE | P00046074 | 01 |
