Elengical, Mary Theresa

Elengical, Mary Theresa is an individual health care provider with primary practice located at 1000 Waterman Way Department Of Anesthesia, Tavares FL 32778-5266. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Elengical, Mary Theresa can be contacted via phone (352) 253-3333.

Contact Information

Primary practice address
1000 Waterman Way Department Of Anesthesia Tavares FL 32778-5266
Phone: (352) 253-3333
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X OS11134 Florida
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 125052315 Illinois

Profile Details

NPI number 1275799637
LBN Legal business name Elengical, Mary Theresa
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2008
Last updated Jan 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275799637 NPPES
Florida Other 14A6M BCBS OF FLORIDA
Florida MEDICAID 002939300 BCBS OF FLORIDA

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