Organization
JEFFREY D MANDELKORN PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY D MANDELKORN PHD (PRESIDENT)
(954) 661-3673
Entity
Organization
Contact information
Practice address
2000 NE 17TH ST, #3, FORT LAUDERDALE, FL 33305-2565
(954) 661-3673
Mailing address
2000 NE 17TH ST, #3, FORT LAUDERDALE, FL 33305-2565
(954) 661-3673
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
PY 8957
FL
Other
Enumeration date
04/01/2014
Last updated
07/24/2014
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