Provider Demographics
NPI:1710318324
Name:MAYUNGBE, ALBERT SR (CPA)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:MAYUNGBE
Suffix:SR
Gender:M
Credentials:CPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 NW 183RD ST STE 402
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4540
Mailing Address - Country:US
Mailing Address - Phone:305-342-1715
Mailing Address - Fax:
Practice Address - Street 1:111 NW 183RD ST STE 402
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4540
Practice Address - Country:US
Practice Address - Phone:305-342-1715
Practice Address - Fax:305-651-4900
Is Sole Proprietor?:No
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993690163W00000X, 164W00000X, 224Z00000X, 225100000X, 2251E1200X, 225200000X, 225X00000X, 225XE1200X, 235Z00000X, 376K00000X
FL16855376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide