Individual
MR. TIMOTHY JOSEPH MANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14055 RIVEREDGE DR STE 250, TAMPA, FL 33637-2141
(813) 929-5451
Mailing address
14055 RIVEREDGE DR STE 250, TAMPA, FL 33637-2141
(813) 929-5451
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036119561
IL
2085R0202X
Diagnostic Radiology Physician
24407
OK
2085R0202X
Diagnostic Radiology Physician
Primary
ME124662
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200056620A
—
OK
Enumeration date
11/21/2005
Last updated
04/09/2025
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