Theodore J Mangru Arnp Inc

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2913662 Issued in FL

Legal business name

THEODORE J MANGRU ARNP INC

Practice address

42 Collins Ave
Miami Beach, FL 33139-7314

Phone

(305) 672-1771

NPI assigned

Sep 28, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Theodore J Mangru, ARNP

Title

Owner

Phone

(305) 439-7987

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285632000000",
    "number": "1386953180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 NW 155TH TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281511",
            "telephone_number": "305-439-7987",
            "fax_number": "305-892-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 COLLINS AVE",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331397314",
            "telephone_number": "305-672-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE J MANGRU ARNP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-09-28",
        "status": "A",
        "authorized_official_last_name": "MANGRU",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-439-7987",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "2913662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Miami Beach, FL
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• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.