Healthcare Provider Details

I. General information

NPI: 1942200753
Provider Name (Legal Business Name): ROBERT W SCARNECCHIA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 S PARROTT AVE
OKEECHOBEE FL
34974-5270
US

IV. Provider business mailing address

604 SW ANCHORAGE WAY
STUART FL
34994-2015
US

V. Phone/Fax

Practice location:
  • Phone: 863-357-3800
  • Fax: 863-357-3808
Mailing address:
  • Phone: 772-418-6191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH7901
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: