Roel Crisostomo Mangaoang
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Juno Beach, FL
NPI 1669067237 · NPPES record last updated Mar 5, 2021
Key facts
- NPI
- 1669067237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- PT7009 (FL)
- Practice address
- 601 Universe Blvd
Juno Beach, FL 33408-2444 - Phone
- (561) 627-3800
- NPI assigned
- Mar 5, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT7009 | FL | MD | Physical Medicine & Rehabilitation Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | PT7009 | FL | Yes |
Addresses
Primary practice location
601 Universe Blvd
Juno Beach, FL 33408-2444
Mailing address
239 Beverly Rd
West Palm Beach, FL 33405-4729
Phone (754) 152-4310
Other providers in Juno Beach, FL
- Anabel Lopez
- Larry Keith Mabry
- Tanya Tricia Magney
- Dawne L Majtenyi
- Marissa Prado Maldonado
- Allison J Manis
- Cara E Marcello
- Mark a Kuhl DMD PA
- Andreina Martinez
- Lauren Ashley Martinez
All providers in Juno Beach, FL · Physical Medicine & Rehabilitation Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.