Individual
ALBERTO MANSILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 200-2355
Mailing address
2600 WESTHALL LN FL 4, MAITLAND, FL 32751-7102
(407) 200-2355
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
ME82584
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME82584
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01683
BCBS OF FLORIDA
FL
05
—
261587800
—
FL
01
—
300124478
RR MEDICARE
FL
Enumeration date
07/07/2005
Last updated
11/22/2023
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