Individual
MANJULA S MANGIPUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
205 DR MARTIN LUTHER KING JR ST N, SUITE 419, ST PETERSBURG, FL 33701-3109
(727) 820-4231
(727) 820-4231
Mailing address
700 S HARBOUR ISLAND BLVD, UNIT 819, TAMPA, FL 33602-5712
(813) 472-9505
(813) 472-9505
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
ME038891
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058380400
—
FL
Enumeration date
10/06/2006
Last updated
11/20/2009
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