Organization
MANGEO ALF INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL RODRIGUEZ (PRESIDENT)
(305) 274-5631
Entity
Organization
Contact information
Practice address
5111 SW 112TH AVE, MIAMI, FL 33165-6941
(305) 274-5631
Mailing address
5111 SW 112 AVE, MIAMI, FL 33165
(305) 274-5631
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002289000
—
FL
Enumeration date
09/22/2010
Last updated
09/22/2010
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