Mangalmurti LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH26261 Issued in FL

Legal business name

MANGALMURTI LLC

Doing business as

Mount Dora Pharmacy

Practice address

17435 US Highway 441
Suite-102
Eustis, FL 32726

Phone

(352) 357-1406

Fax

(352) 357-1402

NPI assigned

May 31, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jimin Patel

Title

Owner

Phone

(352) 357-1406

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mount Dora Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vinod Patel

  • Pharmacist
  • Orlando, FL
  • NPI 1578833406
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1063773679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17435 US HIGHWAY 441 STE 102",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576750",
            "telephone_number": "352-357-1406",
            "fax_number": "352-357-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17435 US HIGHWAY 441",
            "address_2": "SUITE-102",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "32726",
            "telephone_number": "352-357-1406",
            "fax_number": "352-357-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANGALMURTI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-31",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "JIMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-357-1406"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH26261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006612500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2135382",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Dora Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtney Louis
• M.Atiq Hessami,M.D.,P.a.
• Kristin Madan
• Maggies Haven, LLC
• Malaya Care, LLC
• Mangalmurti LLC
• Zaph L Manigat
• John Mansour, PHARMACIST
• Lucas Marcktell
• Maria Lourdes P Burgos , MD

• Community/Retail Pharmacy in Eustis, FL
• Providers in Eustis, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.