Individual
DR. EFSTRATIOS DEMETRIOS LAGOUTARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1361 13TH AVE S, STE 12, JACKSONVILLE BEACH, FL 32250
(904) 241-2655
(904) 249-2425
Mailing address
5911 TIMUQUANA RD UNIT 300, JACKSONVILLE, FL 32210-7897
(904) 251-5053
(904) 224-2002
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO2989
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21698L
BCBS
—
05
—
270008501
—
FL
01
—
DR7381
PALMETTO GBA
—
Enumeration date
08/22/2005
Last updated
02/20/2024
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