Provider Demographics
NPI:1164604120
Name:ANDERMAN, GAYLE MARIE
Entity Type:Individual
Prefix:MRS
First Name:GAYLE
Middle Name:MARIE
Last Name:ANDERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5675 89TH AVE N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-5028
Mailing Address - Country:US
Mailing Address - Phone:413-454-3182
Mailing Address - Fax:
Practice Address - Street 1:5675 89TH AVE N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-5028
Practice Address - Country:US
Practice Address - Phone:413-454-3182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist