Mangonon, Patrick Terry

Mangonon, Patrick Terry is an individual health care provider with primary practice located at 305 Memorial Medical Pkwy Suite 308, Daytona Beach FL 32117-5168. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Mangonon, Patrick Terry can be contacted via phone (386) 231-3600.

Contact Information

Primary practice address
305 Memorial Medical Pkwy Suite 308 Daytona Beach FL 32117-5168
Phone: (386) 231-3600
Fax: (386) 231-3602
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X ME77600 Florida

Profile Details

NPI number 1023067584
LBN Legal business name Mangonon, Patrick Terry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Oct 18th, 2016 - about 10 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 1023067584 NPPES
Florida MEDICAID 256707500

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