Provider Demographics
NPI:1346859741
Name:ANDERSON MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:ANDERSON MEDICAL SERVICES LLC
Other - Org Name:ANDERSON MENTAL HEALTH SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINTARAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZAITIS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, FNP-C
Authorized Official - Phone:954-994-1312
Mailing Address - Street 1:818 NE 28TH ST
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33334-2618
Mailing Address - Country:US
Mailing Address - Phone:954-994-1312
Mailing Address - Fax:954-466-3888
Practice Address - Street 1:1400 E OAKLAND PARK BLVD STE 111
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-4400
Practice Address - Country:US
Practice Address - Phone:954-994-1312
Practice Address - Fax:954-466-3888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty