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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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