Robert Vincent Mandraccia, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

ME0023742 Issued in FL

Practice address

3501 Health Center Blvd Unit 2200
Bonita Springs, FL 34135-8133

Phone

(239) 948-4009

NPI assigned

Apr 12, 2007

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962626879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 HEALTH CENTER BLVD UNIT 2200",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341358133",
            "telephone_number": "239-948-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 HEALTH CENTER BLVD UNIT 2200",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341358133",
            "telephone_number": "239-948-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDRACCIA",
        "first_name": "ROBERT",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME0023742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M&J Compassionate Services LLC
• Larisa Igorevna Macedo, DMD
• Frank Patrick Macias, PHARMD
• Madison American Bonita Springs TRS I, LLC
• Anthony Steven Maltais
• Denise L Manzo, HIS
• Maple Tree Home Health, Inc.
• Marciano Dental Group
• Nicholas Joseph Marciano, DMD
• Margaret a Thomson LCSW

• Plastic and Reconstructive Surgery Physician in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Plastic and Reconstructive Surgery Physician in Florida

• 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.

Verify at the official NPI Registry.