Healthcare Provider Details

I. General information

NPI: 1649188491
Provider Name (Legal Business Name): AMATO THREE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 EAGLE TRCE
MANDEVILLE LA
70471-6762
US

IV. Provider business mailing address

24 EAGLE TRCE
MANDEVILLE LA
70471-6762
US

V. Phone/Fax

Practice location:
  • Phone: 985-353-0540
  • Fax:
Mailing address:
  • Phone: 985-353-0540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ROBERT JOHN AMATO
Title or Position: CEO
Credential: MD
Phone: 985-353-0540