Organization
PATRICK MANGONON MD PA
Active
Other names
DBA FLORIDA THORACIC AND CARDIOVASCULAR SURGEONS
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK T MANGONON MD (PRESIDENT)
(561) 753-7890
Entity
Organization
Contact information
Practice address
13005 SOUTHERN BLVD, SUITE 103, LOXAHATCHEE, FL 33470-9206
(561) 753-7890
(561) 753-7775
Mailing address
PO BOX 210474, ROYAL PALM BEACH, FL 33421-0474
(561) 753-7890
(561) 753-7775
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME77600
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023067584
INDIVIDUAL NPI #
FL
05
—
256707500
—
FL
01
—
P00736326
RAILROAD MEDICARE
FL
Enumeration date
02/21/2007
Last updated
10/01/2009
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