Mischelle Ann Mbonu

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

9414439 Issued in FL

Practice address

411 N Dillard St
Winter Garden, FL 34787-2816

Phone

(407) 296-1600

NPI assigned

Apr 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1871173328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N DILLARD ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347872816",
            "telephone_number": "407-296-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N DILLARD ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347872816",
            "telephone_number": "407-296-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBONU",
        "first_name": "MISCHELLE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "FL",
            "license": "9414439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roderick Mathis
• Ruth Esther Matos, MD
• Victor W Matthews, M.D.
• Maureen Sawh, OD, PLC
• Lovell Leonard Mayle, MD
• Patricia MC Cormick, PT
• MC Medical LLC (Walmart Health)
• Taitlyn Elizabeth McCarthy-Miller
• Michael Douglas McCleary, M.D.
• Jalisa McCleskey

• Administrator Registered Nurse in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Administrator Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.