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General NPI Number Information
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NPI Number | 1528439247
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Entity Type | Organization
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Legal Business Name | DR JOHN RUMBLE
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Dates
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Enumeration Date | 10/08/2015
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Last Update Date | 12/17/2015
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Provider Practice Location Address
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Address Line | 4521 ATLANTIC BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32207-1137
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Country | US
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Telephone | 904-398-8790
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Fax | 904-346-3595
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Provider Business Mailing Address
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Address Line | 4521 ATLANTIC BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32207
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Country | US
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Telephone | 904-398-8970
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Fax | 904-346-3595
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Authorized Official
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Title or Position | ORTHODONTIST ASST
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Name | DACHIA RENEE COOPER
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Credential |
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Telephone | 904-398-8970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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