Individual
AJAY KUMAR MANGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
423 LINDEN LN, LAKE WALES, FL 33853-4342
(863) 676-1960
Mailing address
423 LINDEN LN, LAKE WALES, FL 33853-4342
(863) 676-1960
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
036-124396
IL
207Y00000X
Otolaryngology Physician
35.054717
OH
207Y00000X
Otolaryngology Physician
Primary
ME 110058
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0740658
—
OH
Enumeration date
09/28/2009
Last updated
02/11/2022
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