Provider Demographics
NPI:1326327990
Name:MANNAN, ABOO T (DO)
Entity Type:Individual
Prefix:DR
First Name:ABOO
Middle Name:T
Last Name:MANNAN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6900 TAVISTOCK LAKES BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7592
Mailing Address - Country:US
Mailing Address - Phone:904-745-3618
Mailing Address - Fax:904-722-4271
Practice Address - Street 1:6484 FORT CAROLINE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-2042
Practice Address - Country:US
Practice Address - Phone:904-744-7300
Practice Address - Fax:904-722-4271
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2024-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS12073207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine