Individual
DR. EMAD S MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9981 S HEALTHPARK DR, FORT MYERS, FL 33908-3618
(239) 343-5651
(239) 343-5652
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-5651
(239) 343-5652
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD.11348R
LA
208000000X
Pediatrics Physician
ME0069224
FL
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
ME69224
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275311100
—
FL
Enumeration date
05/11/2006
Last updated
03/29/2021
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