Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | PO3461 | FL |
N | 213ES0000X | Sports Medicine | PO3461 | FL |
Y | 213ES0103X | Foot & Ankle Surgery | PO3461 | FL |
NPI | 1356574651 |
---|---|
Provider Name | Dr. Dock Anderson |
First Address | Bay Harbor Islands, FL 33154-2105 |
Second Address | Bay Harbor Islands, FL 33154-2105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2009 |
Last Update Date | 19/03/2012 |