Nelson-Mangatal, Jacqueline
Nelson-Mangatal, Jacqueline is an sole proprietor health care provider with primary practice located at 3011 Central Ave , St Petersburg FL 33713-8632. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Nelson-Mangatal, Jacqueline can be contacted via phone (786) 316-5044.Contact Information
Primary practice address
3011 Central Ave
St Petersburg FL 33713-8632
Phone: (786) 316-5044
Fax: (727) 328-1971
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN16582 | Florida |
Profile Details
| NPI number | 1154446649 |
|---|---|
| LBN Legal business name | Nelson-Mangatal, Jacqueline |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 21st, 2007 |
| Last updated | Jul 9th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154446649 | NPPES |
| Florida | MEDICAID | 075681400 |
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