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General NPI Number Information
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NPI Number | 1205647666
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Entity Type | Individual
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Provider Name | MAMATHA CHEONG APRN
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Gender | Female
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 9084 NW 23RD PL
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5103
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Country | US
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Telephone | 917-353-2259
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Fax |
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Provider Business Mailing Address
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Address Line | 9084 NW 23RD PL
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5103
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Country | US
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Telephone | 917-353-2259
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11037187
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License Number State | FL
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