Manganello, Larry Joseph

Manganello, Larry Joseph is an individual health care provider with primary practice located at 3001 W Dr Martin Luther King Jr Blvd , Tampa FL 33607-6307. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine. Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine is his primary health care specialty. Manganello, Larry Joseph can be contacted via phone (813) 870-4000.

Contact Information

Primary practice address
3001 W Dr Martin Luther King Jr Blvd Tampa FL 33607-6307
Phone: (813) 870-4000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN2519972 Florida
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X APRN2519972 Florida
Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine 363LC0200X APRN2519972 Florida

Profile Details

NPI number 1215417068
LBN Legal business name Manganello, Larry Joseph
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2018
Last updated Jan 24th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215417068 NPPES
Florida Other H69WA BLUE CROSS BLUE SHIELD
Florida MEDICAID 103924800 BLUE CROSS BLUE SHIELD

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