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Individual

MATTIE B MINGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
402 E WIMBLETON CT APT A, TAMPA, FL 33604-1534
(813) 439-4602
Mailing address
402 E WIMBLETON CT APT A, TAMPA, FL 33604-1534
(813) 439-4602

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
FL

Other

Enumeration date
01/24/2019
Last updated
01/24/2019
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