Individual
JACK A. MANDEL JR.
Active
Individual
JACK A. MANDEL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9299697
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001818300
—
FL
05
—
116242
—
AL
01
—
592-10135
BLUE CROSS BLUE SHIELD
AL
01
—
G0071
BLUE CROSS BLUE SHIELD
FL
01
—
P00810162
MEDICARE RAILROAD
—
Enumeration date
01/13/2010
Last updated
05/03/2010
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