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
Fax: (727) 328-1971
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154446649 NPPES
Florida MEDICAID 075681400

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