Organization
ROSE RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABREONTA MANGO (PROVIDER)
(904) 577-4888
Entity
Organization
Contact information
Practice address
7530 103RD ST STE 4, JACKSONVILLE, FL 32210-6786
(904) 577-4888
Mailing address
8675 VICTORIA FALLS DR FL 32244, JACKSONVILLE, FL 32244-3741
(904) 577-4888
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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