Mandato, Kenneth

Mandato, Kenneth is an individual health care provider with primary practice located at 910 Old Camp Rd Ste 120 , The Villages FL 32162-5605. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Mandato, Kenneth can be contacted via phone (352) 787-5858.

Contact Information

Primary practice address
910 Old Camp Rd Ste 120 The Villages FL 32162-5605
Phone: (352) 787-5858
Fax: (352) 728-6749
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME136921 Florida
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X ME136921 Florida

Profile Details

NPI number 1871677682
LBN Legal business name Mandato, Kenneth
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated May 8th, 2020 - about 4 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 1871677682 NPPES
Florida MEDICAID 104390500

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