Provider Demographics
NPI:1790998482
Name:HUGGINS, MANDY (MD)
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:
Last Name:HUGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2300 N COMMERCE PKWY
Mailing Address - Street 2:SUITE 319
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3254
Mailing Address - Country:US
Mailing Address - Phone:954-217-3111
Mailing Address - Fax:954-217-3240
Practice Address - Street 1:2300 N COMMERCE PKWY
Practice Address - Street 2:SUITE 319
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3254
Practice Address - Country:US
Practice Address - Phone:954-217-3111
Practice Address - Fax:954-217-3240
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2012-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME1106152081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine