Individual
DR. BASIL MANGRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3296N STATE ROAD 7, LAUDERDALE LAKES, FL 33319-5615
(954) 484-6440
(954) 909-5381
Mailing address
3296N STATE ROAD 7, LAUDERDALE LAKES, FL 33319-5615
(954) 484-6440
(954) 909-5381
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
ME62781
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371342300
—
FL
Enumeration date
09/21/2005
Last updated
07/28/2015
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