Organization Active NPI

Mammana Intergrated Physical Medicine Inc

  • General Practice Physician
  • Summerfield, FL
National Provider Identifier
1619592136
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MAMMANA INTERGRATED PHYSICAL MEDICINE INC
Practice address
15151 S US Highway 441 Ste 200
Summerfield, FL 34491-4482
Phone
(352) 307-0033
Fax
(352) 307-1998
NPI assigned
Jun 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Authorized official

Name
Dr. Thomas Frank Mammana, DC
Title
Owner
Phone
(352) 307-0033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

15151 S US Highway 441 Ste 200
Summerfield, FL 34491-4482

Mailing address

15151 S US Highway 441 Ste 200
Summerfield, FL 34491-4482
Phone (352) 307-0033

National Provider Directory

National Provider Directory

Locations

15151 S US Highway 441
Ste 200
Summerfield, FL 34491
Phone (352) 307-0033

NPI Registry JSON

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1619592136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15151 S US HIGHWAY 441 STE 200",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344914482",
            "telephone_number": "352-307-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15151 S US HIGHWAY 441 STE 200",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344914482",
            "telephone_number": "352-307-0033",
            "fax_number": "352-307-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMMANA INTERGRATED PHYSICAL MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "MAMMANA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-307-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerfield, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.