Provider Demographics
NPI:1629090691
Name:MANGINI, JANINE (MD)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:MANGINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5600 BEE RIDGE RD STE C
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1549
Mailing Address - Country:US
Mailing Address - Phone:941-343-8884
Mailing Address - Fax:
Practice Address - Street 1:3355 CLARK RD STE 102
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8400
Practice Address - Country:US
Practice Address - Phone:941-312-2730
Practice Address - Fax:941-870-8941
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85123207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MII12914Medicare UPIN