Individual
KIMBERLY MANGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1239 E MAIN ST, BARTOW, FL 33830-5058
(863) 519-0575
(863) 582-9251
Mailing address
PO BOX 1559, BARTOW, FL 33831-1559
(863) 519-0575
(863) 582-9251
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9339286
FL
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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