Provider Demographics
NPI:1720214240
Name:ANDERSON, MINDI ASHLEY (APRN, CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:MINDI
Middle Name:ASHLEY
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3628 DEER OAK CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-8110
Mailing Address - Country:US
Mailing Address - Phone:817-714-6222
Mailing Address - Fax:
Practice Address - Street 1:12201 RESEARCH PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-3265
Practice Address - Country:US
Practice Address - Phone:407-823-1956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9404211363LP0200X
TX595842208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics