Active NPI
Jyl A Mangooni, MBA, ATC, LAT
- Athletic Trainer
- Babson Park, FL
National Provider Identifier
1295885242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL 1832
- Practice address
- 1201 N Scenic Hwy
Babson Park, FL 33827-9751 - Phone
- (863) 638-2949
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL 1832 | FL | Primary |
Addresses
Primary practice location
1201 N Scenic Hwy
Babson Park, FL 33827-9751
Mailing address
1071 Cascade Cir
Rockledge, FL 32955-8083
Phone (321) 961-5593
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL 1832 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295885242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1071 CASCADE CIR",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329558083",
"telephone_number": "321-961-5593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 N SCENIC HWY",
"city": "BABSON PARK",
"state": "FL",
"postal_code": "338279751",
"telephone_number": "863-638-2949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGOONI",
"first_name": "JYL",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "MBA, ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL 1832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Babson Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.