Provider Demographics
NPI:1982988341
Name:MANN, ROBERT MAXWELL (CCA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MAXWELL
Last Name:MANN
Suffix:
Gender:M
Credentials:CCA
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Mailing Address - Street 1:PO BOX 100435
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0435
Mailing Address - Country:US
Mailing Address - Phone:352-278-1111
Mailing Address - Fax:352-846-2683
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:SUITE D1.11
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-6930
Practice Address - Fax:352-846-2683
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologist