Individual
GINA DELLACGUA MANGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
7335 W SAND LAKE RD, SUITE 200, ORLANDO, FL 32819-5538
(407) 352-8553
(407) 351-8412
Mailing address
7335 W SAND LAKE RD, SUITE 200, ORLANDO, FL 32819-5538
(407) 352-8553
(407) 351-8412
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9104450
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y0HS6
BCBS
FL
Enumeration date
05/02/2006
Last updated
01/23/2015
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