Mangrum, Amy K

Mangrum, Amy K is an individual health care provider with primary practice located at 1100 Nw 9Th Pl , Cape Coral FL 33993-6061. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Mangrum, Amy K can be contacted via phone (123) 924-5403.

Contact Information

Primary practice address
1100 Nw 9Th Pl Cape Coral FL 33993-6061
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X Florida

Profile Details

NPI number 1720603228
LBN Legal business name Mangrum, Amy K
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2020
Last updated Jun 10th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720603228 NPPES
Florida MEDICAID 105007600

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