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Organization
LAUDERDALE LAKES MEDICAL CENTER, INC.
Active
Organization
LAUDERDALE LAKES MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASIL MANGRA M.D. (OWNER/PHYSICIAN)
(954) 484-6440
Entity
Organization
Contact information
Practice address
3296 N STATE ROAD 7, LAUDERDALE LAKES, FL 33319-5615
(954) 484-6440
(954) 909-5381
Mailing address
3296 N STATE ROAD 7, LAUDERDALE LAKES, FL 33319-5615
(954) 484-6440
(954) 909-5381
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME62781
FL
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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