Organization
MANGO PHARMACY LLC
Active
Other names
Mango Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALPESH PATEL (OWNER)
(813) 661-2263
Entity
Organization
Contact information
Practice address
11509 DR MARTIN LUTHER KING JR BLVD, MANGO, FL 33550
(813) 661-2263
(813) 662-2263
Mailing address
11509 DR. MARTIN LUTHER KING JR. BLVD, MANGO, FL 33550
(813) 661-2263
(813) 662-2263
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH29956
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017041900
—
FL
01
—
2158271
PK
—
Enumeration date
07/26/2010
Last updated
07/09/2021
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