MEDICARE: ROBERT LEE LAMPMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1750931846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LEE LAMPMAN

Provider Business Mailing Address
First Line	:	9811 W CHARLESTON BLVD # 2-641
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7528
Country	:	US
Telephone Number	:	855-864-4322
Fax Number	:	866-540-2867

Provider Business Practice Location Address
First Line	:	1913 NE 21ST AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33305-2524
Country	:	US
Telephone Number	:	855-864-4322
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2019
Last Update Date	:	09/19/2019

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