Individual ProviderKrista AndersenPediatricsAllopathic & Osteopathic PhysiciansPractice Address9611 W Broward Blvd, Plantation, FL 33324-2334(954) 424-7000(813) 699-3995PECOS EnrollmentBased on the most recent information from CMS, provider Krista Andersen 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 15 days ago.Profile DetailsProvider ID1932461217Provider TypeIndividualFull NameAndersen, KristaCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date6/12/2012Last Updated7/3/2023Contact InformationPractice LocationPractice Address9611 W Broward Blvd, Plantation, FL 33324-2334Phone(954) 424-7000FaxUnlisted FaxMailing LocationMailing Address900 S Pine Island Rd Ste 800, Plantation, FL 33324-3923Phone(813) 699-3995Fax(813) 315-1625Provider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseME146983FloridaCode208000000XDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicense35.125955OhioProvider IdentifiersIDDescriptionIssuerID108043500DescriptionMedicaidIssuerUnlistedFlorida