Organization
EMMANUEL LAGOUTARIS, DPM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMANUEL LAGOUTARIS D.P.M. (OWNER)
(904) 429-9859
Entity
Organization
Contact information
Practice address
300 KINGSLEY LAKE DR, STE. 402, ST AUGUSTINE, FL 32092-3037
(904) 429-9859
Mailing address
300 KINGSLEY LAKE DR, STE. 402, ST AUGUSTINE, FL 32092-3037
(904) 429-9859
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3053
FL
Other
Enumeration date
02/15/2015
Last updated
12/23/2016
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