# MAMMANA INTERGRATED PHYSICAL MEDICINE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619592136
- **Authorized official:** DR. THOMAS FRANK MAMMANA DC (OWNER)
- **Authorized official phone:** (352) 307-0033

## Contact information

- **Practice address:** 15151 S US HIGHWAY 441 STE 200, SUMMERFIELD, FL 34491-4482
- **Practice address phone:** (352) 307-0033
- **Practice address fax:** (352) 307-1998
- **Mailing address:** 15151 S US HIGHWAY 441 STE 200, SUMMERFIELD, FL 34491-4482
- **Mailing address phone:** (352) 307-0033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/10/2020
- **Last updated:** 09/17/2020