Anderson, Luis M

Anderson, Luis M is an individual health care provider with primary practice located at 3670 Us 1 S Ste 300B , Saint Augustine FL 32086-6354. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Anderson, Luis M can be contacted via phone (904) 479-9501.

Contact Information

Primary practice address
3670 Us 1 S Ste 300B Saint Augustine FL 32086-6354
Phone: (904) 479-9501
Fax: (904) 217-0524
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME0089595 Florida

Profile Details

NPI number 1649337635
LBN Legal business name Anderson, Luis M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2007
Last updated Feb 1st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649337635 NPPES
Florida Other 37560 BCBS
Florida MEDICAID 269304600 BCBS
Florida Other 7201378 BCBS
Florida Other 650598984 BCBS

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