MEDICARE: MR. SCOTT MANGINI

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
1	183500000X	Pharmacist	PS24945	FL

General Provider Information

NPI Number	:	1730307901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT MANGINI

Provider Business Mailing Address
First Line	:	2320 ALFORD WAY
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-7771
Country	:	US
Telephone Number	:	561-784-9654
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 ROYAL PALM BEACH BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1641
Country	:	US
Telephone Number	:	561-793-8312
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/08/2007

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Directions to “ MR. SCOTT MANGINI ” Practice Location

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