Provider Demographics
NPI:1487924908
Name:ANDERSON, MAUREEN A (PHARMD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:A
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 NW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-5698
Mailing Address - Country:US
Mailing Address - Phone:352-339-7474
Mailing Address - Fax:352-260-0811
Practice Address - Street 1:203 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5698
Practice Address - Country:US
Practice Address - Phone:352-339-7474
Practice Address - Fax:352-260-0811
Is Sole Proprietor?:No
Enumeration Date:2012-01-02
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist