Organization
ROBERT A IANNACONE DPM, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A IANNACONE DPM (OWNER)
(772) 878-0040
Entity
Organization
Contact information
Practice address
691 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-1998
(772) 878-0040
Mailing address
691 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-1998
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO2344
FL
Other
Enumeration date
02/10/2017
Last updated
02/10/2017
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