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General NPI Number Information
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NPI Number | 1336905116
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Entity Type | Organization
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Legal Business Name | MANGO HEALTH LLC
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 1490 SE MAGNOLIA EXT
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City | OCALA
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State | FL
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Zip | 34471-4443
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Country | US
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Telephone | 352-512-9703
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Fax |
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Provider Business Mailing Address
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Address Line | 8051 N TAMIAMI TRL STE E6
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City | SARASOTA
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State | FL
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Zip | 34243-2067
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Country | US
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Telephone | 352-333-5980
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALI MAZHAR RANA
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Credential |
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Telephone | 352-333-5980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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