Provider Demographics
NPI:1689735631
Name:MANGIONE, TODD PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:PAUL
Last Name:MANGIONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 198054
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8054
Mailing Address - Country:US
Mailing Address - Phone:305-271-9777
Mailing Address - Fax:786-533-9361
Practice Address - Street 1:975 BAPTIST WAY STE 201
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7600
Practice Address - Country:US
Practice Address - Phone:305-271-9777
Practice Address - Fax:786-533-9361
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS10446208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery