Provider Demographics
NPI:1942200753
Name:SCARNECCHIA, ROBERT W (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:SCARNECCHIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 SW ANCHORAGE WAY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2015
Mailing Address - Country:US
Mailing Address - Phone:772-418-6191
Mailing Address - Fax:
Practice Address - Street 1:1140 S PARROTT AVE
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34974-5270
Practice Address - Country:US
Practice Address - Phone:863-357-3800
Practice Address - Fax:863-357-3808
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor