Individual
MR. MANGESH SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2415 N ORANGE AVE STE 200, ORLANDO, FL 32804-5505
(407) 303-1812
(407) 303-1815
Mailing address
2415 N ORANGE AVE STE 200, ORLANDO, FL 32804-5505
(407) 303-1812
(407) 303-1815
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
18418
AL
207RG0100X
Gastroenterology Physician
Primary
ME126351
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009954105
—
AL
05
—
016838000
—
FL
01
—
VA025
MEDICARE HF
FL
Enumeration date
07/05/2006
Last updated
04/25/2025
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