Organization
MANGO WELLNESS LLC
Active
Organization
MANGO WELLNESS LLC
Active
Parent organization
MANGOWELLNESS LLC
Other names
MANGOWELLNESS
Organization subpart
Yes
Provider details
NPI number
Legal business name
MANGOWELLNESS LLC
Authorized official
SIBY THOMAS PUTHENPURAYIL PHARMD (OWNER/AUTHORIZED OFFICIAL)
(407) 593-2958
Entity
Organization
Contact information
Practice address
2801 13TH ST, SAINT CLOUD, FL 34769-4134
(407) 593-2958
(407) 593-2957
Mailing address
2801 13TH ST, SAINT CLOUD, FL 34769-4134
(407) 593-2958
(407) 593-2957
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
07/24/2025
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