Individual
AVINASH MAMGAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1100
Mailing address
600 S PAULINA ST STE 403, CHICAGO, IL 60612-3806
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4413
FL
Other
Enumeration date
05/06/2022
Last updated
04/25/2024
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