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Individual

MICHAEL JAMES MONGIELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN, MA, NP-C, RN

Contact information

Practice address
8925 COLONIAL CENTER DR STE 2001, FORT MYERS, FL 33905
(239) 343-9567
(239) 343-6571
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9567
(239) 343-9571

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN9382978
FL
364SX0200X
Oncology Clinical Nurse Specialist
APRN9382978
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022992200
FL
Enumeration date
10/11/2017
Last updated
03/31/2021
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