Individual
DAVID ETHAN MAMBU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2413 FALLEN TREE DR W, JACKSONVILLE, FL 32246-4141
(571) 330-4633
Mailing address
2413 FALLEN TREE DR W, JACKSONVILLE, FL 32246-4141
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11044264
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11044264
FL
Other
Enumeration date
10/14/2025
Last updated
12/18/2025
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