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NPI Code Detail

MEDICARE: AUSTYN MANGINI MSN, RN, CPNP-AC

MEDICARE: AUSTYN MANGINI MSN, RN, CPNP-AC
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
1363LP0200XPediatric Nurse Practitioner4704291944MI

General Provider Information

NPI Number : 1821569260
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUSTYN MANGINI MSN, RN, CPNP-AC
Provider Business Mailing Address
First Line : 9731 NW 58TH CT
Second Line :
City : PARKLAND
State : FL
Zip : 33076-1830
Country : US
Telephone Number : 248-227-4217
Fax Number :
Provider Business Practice Location Address
First Line : 3100 SW 62ND AVE
Second Line :
City : MIAMI
State : FL
Zip : 33155-3009
Country : US
Telephone Number : 561-624-9188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2018
Last Update Date : 08/06/2024

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