# FILOLI INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mango Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295290310
- **Authorized official:** ANTON FETKULOV (PRACTICE MANAGER)
- **Authorized official phone:** (786) 391-0269

## Contact information

- **Practice address:** 434 SW 12TH AVE STE 205, MIAMI, FL 33130-2432
- **Practice address phone:** (786) 391-0269
- **Practice address fax:** (786) 391-1694
- **Mailing address:** 434 SW 12TH AVE STE 205, MIAMI, FL 33130-2432
- **Mailing address phone:** (786) 391-0269
- **Mailing address fax:** (786) 391-1694

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/02/2019
- **Last updated:** 02/02/2019