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Individual

DR. MANGALA J SHETTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1737A SE 28TH LOOP, OCALA, FL 34471
(352) 622-1840
(352) 622-0157
Mailing address
11350 MCCORMICK RD, EXECUTIVE PLAZA 1, STE. 501, HUNT VALLEY, MD 21031-4002
(703) 914-8000
(631) 329-6951

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME75986
FL
208VP0000X
Pain Medicine Physician
Primary
ME75986
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
254258700
FL
Enumeration date
07/18/2006
Last updated
01/28/2022
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