Provider Demographics
NPI:1609824432
Name:ANDERSON, NORMAN H (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:H
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 SE 17TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4118
Mailing Address - Country:US
Mailing Address - Phone:352-732-0277
Mailing Address - Fax:352-414-5088
Practice Address - Street 1:2020 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4118
Practice Address - Country:US
Practice Address - Phone:352-732-0277
Practice Address - Fax:352-861-1869
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME425532085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL046919000Medicaid
FL046919000Medicaid
FLD54812Medicare UPIN