Organization
FH MANGUNDAYAO & FC MANGUNDAYAO PTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FLORITA C MANGUNDAYAO M.D. (M.D.)
(336) 859-2121
Entity
Organization
Contact information
Practice address
292 SOUTH MAIN ST., DENTON, NC 27239-1374
(336) 859-2121
(336) 859-2122
Mailing address
PO BOX 1374, 292 SOUTH MAIN ST., DENTON, NC 27239-1374
(336) 859-2121
(336) 859-2122
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
22000
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619165164
GROUP NPI FOR MEDICARE
NC
Enumeration date
10/10/2007
Last updated
09/24/2009
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