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General NPI Number Information
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NPI Number | 1720583651
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Entity Type | Individual
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Provider Name | MICHELLE MANGOLD DO
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Gender | Female
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1 TAMPA GENERAL CIR
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City | TAMPA
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State | FL
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Zip | 33606-3571
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Country | US
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Telephone | 210-589-9846
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Fax |
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Provider Business Mailing Address
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Address Line | 2428 OAK LANDING DR
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City | BRANDON
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State | FL
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Zip | 33511-7607
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Country | US
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Telephone | 210-589-9846
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | OS22424
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License Number State | FL
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