Organization
FILOLI INC
Active
Other names
Mango Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANTON FETKULOV (PRACTICE MANAGER)
(786) 391-0269
Entity
Organization
Contact information
Practice address
434 SW 12TH AVE STE 205, MIAMI, FL 33130-2432
(786) 391-0269
(786) 391-1694
Mailing address
434 SW 12TH AVE STE 205, MIAMI, FL 33130-2432
(786) 391-0269
(786) 391-1694
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/02/2019
Last updated
02/02/2019
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