Individual
MRS. EMILY A MANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2165 LITTLE RD, TRINITY, FL 34655-4410
(727) 372-6637
(727) 807-7392
Mailing address
2165 LITTLE RD, TRINITY, FL 34655-4410
(727) 372-6637
(727) 807-7392
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104221
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA 9104221
STATE OF FLORIDA LIC
FL
Enumeration date
10/16/2007
Last updated
08/15/2012
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