MEDICARE: KRISTA MARIE MANTAY RINGEY RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	ND 6551	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255728283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA MARIE MANTAY RINGEY RD

Provider Business Mailing Address
First Line	:	PO BOX 100325
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32610-0325
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 SW ARCHER RD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-1134
Country	:	US
Telephone Number	:	352-265-0111
Fax Number	:	352-265-1071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2015
Last Update Date	:	02/19/2026

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