Provider Demographics
NPI:1023548013
Name:LOMBARDO, ROBERT J
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:LOMBARDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 SAWGRASS VILLAGE CIR STE 23
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32082-5041
Mailing Address - Country:US
Mailing Address - Phone:904-280-0070
Mailing Address - Fax:904-280-0079
Practice Address - Street 1:5000 SAWGRASS VILLAGE CIR STE 23
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32082-5041
Practice Address - Country:US
Practice Address - Phone:904-280-0070
Practice Address - Fax:904-280-0079
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN22725122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist