Individual provider Active NPI

Leslie Mangual, NP-C

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1194149369
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9295382 Issued in FL
Practice address
5611 Sheldon Rd
Tampa, FL 33615-3532
Phone
(813) 397-5320
Fax
(813) 866-0929
NPI assigned
Feb 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9295382 FL Primary

Addresses

Primary practice location

5611 Sheldon Rd
Tampa, FL 33615-3532

Mailing address

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916-2216
Phone (239) 274-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140417001517 FL Practitioner - Nurse Practitioner 7315179702 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Mar 5, 2018 Accepting new patients

Locations

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

3402 W Dr Martin Luther King Jr Blvd
Fl Cancer
Tampa, FL 33607
Phone (813) 875-3950

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1391904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1194149369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 VERONICA S SHOEMAKER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162216",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5611 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153532",
            "telephone_number": "813-397-5320",
            "fax_number": "813-866-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUAL",
        "first_name": "LESLIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-09",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9295382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.