Individual
STACY ALLISON MANDRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2415 N ORANGE AVE STE 700, ORLANDO, FL 32804-5521
(407) 303-2474
(407) 303-0680
Mailing address
2415 N ORANGE AVE STE 700, ORLANDO, FL 32804-5521
(407) 303-2474
(407) 303-0680
Taxonomy
Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
MD.203226
LA
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
ME144091
FL
207RC0000X
Cardiovascular Disease Physician
2006015684
MO
207RC0000X
Cardiovascular Disease Physician
MD.203226
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07720531
—
MS
05
—
1889938
—
LA
01
—
2006015684
LICENSE NUMBER
MO
Enumeration date
05/08/2007
Last updated
08/19/2020
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