Roel Crisostomo Mangaoang

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT7009 Issued in FL

Practice address

601 Universe Blvd
Juno Beach, FL 33408-2444

Phone

(561) 627-3800

NPI assigned

Mar 5, 2021

Last updated

Mar 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1669067237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 BEVERLY RD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334054729",
            "telephone_number": "754-152-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 UNIVERSE BLVD",
            "city": "JUNO BEACH",
            "state": "FL",
            "postal_code": "334082444",
            "telephone_number": "561-627-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAOANG",
        "first_name": "ROEL",
        "middle_name": "CRISOSTOMO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "PT7009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anabel Lopez, LMT
• Larry Keith Mabry, L.C.S.W.
• Tanya Tricia Magney
• Dawne L Majtenyi
• Marissa Prado Maldonado
• Allison J Manis, D.C.
• Cara E Marcello
• Mark a Kuhl DMD PA
• Andreina Martinez, LICENCES MASSAGE THE
• Lauren Ashley Martinez

• Physical Medicine & Rehabilitation Physician in Juno Beach, FL
• Providers in Juno Beach, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.