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General NPI Number Information
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NPI Number | 1407069818
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Entity Type | Individual
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Provider Name | STACY ALLISON MANDRAS MD
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 2415 N ORANGE AVE STE 700
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City | ORLANDO
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State | FL
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Zip | 32804-5521
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Country | US
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Telephone | 407-303-2474
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Fax | 407-303-0680
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Provider Business Mailing Address
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Address Line | 2415 N ORANGE AVE STE 700
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City | ORLANDO
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State | FL
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Zip | 32804-5521
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Country | US
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Telephone | 407-303-2474
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Fax | 407-303-0680
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | MD.203226
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2006015684
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD.203226
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | ME144091
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License Number State | FL
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