Provider Demographics
NPI:1518751528
Name:MANTRIPRAGADA, MOWNIKA (DO)
Entity type:Individual
Prefix:
First Name:MOWNIKA
Middle Name:
Last Name:MANTRIPRAGADA
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 HANNAH WAY S
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-9451
Mailing Address - Country:US
Mailing Address - Phone:510-709-7682
Mailing Address - Fax:
Practice Address - Street 1:405 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-7538
Practice Address - Country:US
Practice Address - Phone:937-723-3248
Practice Address - Fax:937-723-5017
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program