Individual
JOSE MAURICIO MONGALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16560 SW 52ND ST, MIAMI, FL 33185-5189
(786) 859-9462
Mailing address
16560 SW 52ND ST, MIAMI, FL 33185-5189
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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