| Kenneth Mandato, | |
|
910 Old Camp Rd Ste 120, The Villages, FL 32162-5605 | |
| (352) 787-5858 | |
| (352) 728-6749 |
| Full Name | Kenneth Mandato |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 31 Years |
| Location | 910 Old Camp Rd Ste 120, The Villages, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871677682 | NPI | - | NPPES |
| 104390500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | ME136921 (Florida) | Secondary |
| 2085R0204X | Radiology - Vascular & Interventional Radiology | ME136921 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Uf Health Leesburg Hospital | Leesburg, FL | Hospital |
| Villages Regional Hospital, The | The villages, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lake Medical Imaging And Breast Center At The Villages Llc | 0042116865 | 21 |
| Radiology Associates Of Central Florida L L C | 7214833003 | 6 |
| Entity Name | Lake Medical Imaging And Breast Center At The Villages Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770541633 PECOS PAC ID: 0042116865 Enrollment ID: O20031211000187 |
| Entity Name | Radiology Associates Of Central Florida L L C |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184689127 PECOS PAC ID: 7214833003 Enrollment ID: O20031211000531 |
| Entity Name | Hem Onc Associates Of The Treasure Coast, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205882867 PECOS PAC ID: 2961416136 Enrollment ID: O20060127000053 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Mandato, 801 E Dixie Ave Ste 104, Leesburg, FL 34748-7601 Ph: (352) 787-5858 | Kenneth Mandato, 910 Old Camp Rd Ste 120, The Villages, FL 32162-5605 Ph: (352) 787-5858 |
Dr. Prashant Arun Desai, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2955 Brownwood Blvd Ste 107, The Villages, FL 32163 Phone: 352-765-7100 Fax: 352-430-0210 | |
Rafik Ben Abda, D.O Radiology Medicare: Accepting Medicare Assignments Practice Location: 2955 Brownwood Blvd Ste 112, The Villages, FL 32163 Phone: 352-787-5858 | |
Kyle Alan Hopkins, PA Radiology Medicare: Accepting Medicare Assignments Practice Location: 910 Old Camp Rd Ste 120, The Villages, FL 32162 Phone: 352-787-5858 Fax: 352-787-4655 | |
Robert Lake Purdon, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1540 Clemente Ct, The Villages, FL 32159 Phone: 352-259-2200 Fax: 352-259-2203 | |
Ahmet Sacit Tunceroglu, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1540 Clemente Ct, The Villages, FL 32159 Phone: 352-259-2200 Fax: 352-581-6210 | |
Pranab Ray, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 11950 County Road 101, Suite 105, The Villages, FL 32162 Phone: 352-391-6190 Fax: 352-391-6199 | |
Mrs. Marta E Heaberlin, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1400 N Us Highway 441 Ste 510, The Villages, FL 32159 Phone: 352-787-5858 |