Individual
ROBERT KING JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
711 CRESTLINE AVE S, LEHIGH ACRES, FL 33974-0723
(239) 980-2559
Mailing address
PO BOX 81464, CONYERS, GA 30013-9419
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
12740
FL
Other
Enumeration date
08/21/2016
Last updated
08/21/2016
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