Individual
PAUL MICHAEL ROBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
273 ECHO CIR, FORT WALTON BEACH, FL 32548-6314
(850) 585-3140
Mailing address
273 ECHO CIR, FORT WALTON BEACH, FL 32548-6314
(850) 585-3140
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5155785
FL
Other
Enumeration date
01/26/2011
Last updated
01/26/2011
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