Individual
MARK VINCENT MANDESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
1717 S ORANGE AVE, ORLANDO, FL 32806-2944
(407) 422-6798
(407) 992-7053
Mailing address
540 GOLDENMOSS LOOP, OCOEE, FL 34761-4783
(407) 234-5788
(407) 992-7053
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
3019
FL
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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