Individual
JACOB MANGOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8451 US 301 S, RIVERVIEW, FL 33578-5450
(813) 359-9940
Mailing address
601 CLEVELAND ST STE 330, CLEARWATER, FL 33755-4185
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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