KENNETH MANDATO (NPI# 1871677682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871677682 |
| Entity Type | Individual |
| Full Name | KENNETH MANDATO |
| Practice Address |
910 Old Camp Rd Ste 120 The Villages FL 32162-5605 |
| Mailing Address |
801 E Dixie Ave Ste 104 Leesburg FL 34748-7601 |
| Practice Telephone | 3527875858 |
| Practice Fax Number | 3527286749 |
| Mailing Telephone | 3527875858 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME136921 | FL | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
ME136921 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 104390500 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 801 E Dixie Ave Ste 104, Leesburg, FL 347487601 | 3527875858 | 3527286749 |
| Street Address |
910 OLD CAMP RD STE 120 |
| City | THE VILLAGES |
| State | FL |
| Zip Code | 32162-5605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831700939 | Lana Nesheiwat | Pharmacist | 2235 Parr Drive, Lady Lake, FL 32162 | 2020-08-12 |
| 1619591393 | Advanced Periodontics & Implant Care, LLC | Dentist | 1950 Laurel Manor Drive #184, The Villages, FL 32162 | 2020-05-29 |
| 1639719081 | Retirement Five, LLC | Skilled Nursing Facility | 16605 Se 74th Souiliere Ave, The Villages, FL 32162 | 2020-01-14 |
| 1184263261 | Eric William Allen | Pharmacist | Win Dixie Pharmacy #2545, 2500 Burnsed Blvd, The Villages, FL 32162 | 2020-01-06 |
| 1740828391 | Tara Maria Jennings Irwin | Physical Therapy Assistant | 11962 Cr 101 #104, The Villages, FL 32162 | 2019-12-13 |
| 1851819254 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 310 Longview Ave, Lady Lake, FL 32162 | 2017-09-06 |
| 1033642327 | Ben Miller | Specialist/Technologist | 251 Buffalo Trl, The Villages, FL 32162 | 2017-04-04 |
| 1932631173 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 620 Kristine Way, The Villages, FL 32162 | 2017-03-28 |
| 1639534522 | Pamela Marie Bureau | Registered Nurse | 1020 Lake Sumter Landing, The Villages, FL 32162 | 2015-12-21 |
| 1669847059 | Dawn Johnson | Dental Assistant | 8900 Mulberry Ln, The Villages, FL 32162 | 2015-12-10 |
| Find all providers in zip 32162 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100917 | Emergency and Interventional Specialists, Inc | Radiology | 5626 Gulf Dr Ste 100, New Port Richey, FL 34652-4020 | 2020-09-23 |
| 1548879794 | Vascular Specialist of Venice and Sarasota Pl | Radiology | 6600 University Parkway, #102, Sarasota, FL 34240 | 2020-07-23 |
| 1164060497 | Advanced Vascular Cardiac & Veins, Pllc | Radiology | 7480 Bird Rd Ste 560, Miami, FL 33155-6657 | 2019-12-17 |
| 1801437041 | Premier Interventional & Diagnostic Radiology, Corp | Radiology | 8495 Sw 56th St, Miami, FL 33155-5426 | 2019-09-30 |
| 1003476169 | Hss-florida Physicians LLC | Radiology | 1395 S State Road 7 Ste 410, Wellington, FL 33414-9327 | 2019-06-19 |
| 1003302712 | Ocuflow Doppler LLC | Radiology | 1855 Veterans Park Drive, Naples, FL 34109 | 2018-07-05 |
| 1972006351 | Minimally Invasive Vascular, Inc | Radiology | 2720 Us Highway 1 S Ste C, St Augustine, FL 32086-6301 | 2018-03-13 |
| 1124530761 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 313 W Bass St, Kissimmee, FL 34741-5011 | 2017-11-03 |
| 1942727516 | Inspired Interventional Radiology Services LLC | Radiology | 11011 Sheridan St Ste 102, Hollywood, FL 33026-1501 | 2017-08-24 |
| 1386004901 | Precision Medical Imaging and Therapeutic Institute LLC | Radiology | 2540 Green Forest Ln, Suite #101, Lutz, FL 33558-5388 | 2016-02-24 |
| Find all providers with the same taxonomy | ||||
| City | THE VILLAGES |
| Zip Code | 32162 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.