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Individual

MR. JOHN WAYNE ROYALTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3402 N LECANTO HWY, STE C, BEVERLY HILLS, FL 34465-3570
(352) 563-5488
(352) 563-6328
Mailing address
3402 N LECANTO HWY, STE C, BEVERLY HILLS, FL 34465-3570
(352) 563-5488
(352) 563-6328

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
056237
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
372553700
FL
Enumeration date
06/10/2005
Last updated
02/06/2015
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