Individual
JEAN-CLAUDE DESMANGLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5153 N 9TH AVE, PENSACOLA, FL 32504-8785
(850) 505-4700
(850) 505-4711
Mailing address
10140 CENTURION PKWY N, PROVIDER ENROLLMENT DEPARTMENT, JACKSONVILLE, FL 32256-0532
(904) 697-4127
(904) 697-5102
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
21660
NE
2080P0205X
Pediatric Endocrinology Physician
Primary
ME128277
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018049900
—
FL
05
—
03920445
—
NY
Enumeration date
08/20/2006
Last updated
07/21/2022
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