Provider Demographics
NPI:1336905116
Name:MANGO HEALTH LLC
Entity Type:Organization
Organization Name:MANGO HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:MAZHAR
Authorized Official - Last Name:RANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-333-5980
Mailing Address - Street 1:8051 N TAMIAMI TRL STE E6
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2067
Mailing Address - Country:US
Mailing Address - Phone:352-333-5980
Mailing Address - Fax:
Practice Address - Street 1:1490 SE MAGNOLIA EXT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4443
Practice Address - Country:US
Practice Address - Phone:352-512-9703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty