Kristy M Mangano

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-26414 Issued in FL

Practice address

12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486

Phone

(386) 944-5513

Fax

(772) 675-9100

NPI assigned

Jun 19, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1073927729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12724 GRAN BAY PKWY W STE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589486",
            "telephone_number": "386-944-5513",
            "fax_number": "772-675-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Air Park Dr",
            "address_purpose": "LOCATION",
            "city": "Ronkonkoma",
            "state": "NY",
            "postal_code": "117797360",
            "country_code": "US",
            "telephone_number": "631-580-4071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 W Cypress Creek Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333091947",
            "country_code": "US",
            "telephone_number": "855-832-6727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGANO",
        "first_name": "KRISTY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-17-26414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lishen Angelie Maneja
• Anna Manelis, DPT, PH.D.
• Caroline Danell Manemann, DPT
• Shailey Nicole Manfredo
• Lauren Alexandra Manganiello, MD
• Kelsie Roeisha Mangar
• Clara Julianne Mangin
• Rachel Gupton Mangine
• Abreonta Mango
• Mikaila Angeli-Olmedo Mangubat

• Behavior Analyst in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.