Individual
DR. ROBERT CORNELIUS LUTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP EMERGENCY MEDICINE, JACKSONVILLE, FL 32209-6511
(904) 244-7234
(904) 244-4508
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME34114
FL
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
ME34114
FL
208000000X
Pediatrics Physician
ME34114
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000218908A
—
GA
05
—
0399078-00
—
FL
01
—
930003868
RAILROAD MEDICARE
FL
Enumeration date
01/28/2006
Last updated
07/27/2010
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