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General NPI Number Information
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NPI Number | 1417148024
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Entity Type | Individual
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Provider Name | DARRIN RICHARD MANGIACARNE D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 7859 LAKE WORTH RD
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City | LAKE WORTH
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State | FL
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Zip | 33467-3225
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Country | US
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Telephone | 561-465-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 225 N FEDERAL HWY
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City | POMPANO BEACH
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State | FL
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Zip | 33062-4319
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Country | US
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Telephone | 561-465-1000
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Fax |
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 0102203536
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | OS014185
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 21086
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 02004594A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | OS14247
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License Number State | FL
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