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Organization
THEODORE J MANGRU ARNP INC
Active
Organization
THEODORE J MANGRU ARNP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE J MANGRU ARNP (OWNER)
(305) 439-7987
Entity
Organization
Contact information
Practice address
42 COLLINS AVE, MIAMI BEACH, FL 33139-7314
(305) 672-1771
Mailing address
731 NW 155TH TER, PEMBROKE PINES, FL 33028-1511
(305) 439-7987
(305) 892-6735
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2913662
FL
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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