Individual ProviderLisa AndersonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4101 Southpoint Dr E, Jacksonville, FL 32216-0996(904) 296-6800(508) 208-1322PECOS EnrollmentBased on the most recent information from CMS, provider Lisa Anderson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1821115288Provider TypeIndividualFull NameAnderson, LisaCredentialP.T.GenderFemaleSole ProprietorYesEnumeration Date3/23/2007Last Updated8/17/2015Contact InformationPractice LocationPractice Address4101 Southpoint Dr E, Jacksonville, FL 32216-0996Phone(904) 296-6800FaxUnlisted FaxMailing LocationMailing Address140 Crosstide Cir, Ponte Vedra Beach, FL 32082-4028Phone(508) 208-1322FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense26921FloridaCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense8630Massachusetts