Individual
MARY THERESA ELENGICAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1000 WATERMAN WAY, DEPARTMENT OF ANESTHESIA, TAVARES, FL 32778-5266
(352) 253-3333
Mailing address
PO BOX 3130, OCALA, FL 34478-3130
(352) 867-8311
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125052315
IL
207L00000X
Anesthesiology Physician
Primary
OS11134
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002939300
—
FL
01
—
14A6M
BCBS OF FLORIDA
FL
Enumeration date
08/05/2008
Last updated
01/06/2011
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