Organization
MARK AND KAMBOUR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GRATTENDICK (CFO)
(561) 514-5822
Entity
Organization
Contact information
Practice address
16250 NW 59TH AVE STE 201, MIAMI LAKES, FL 33014-7542
(305) 825-4422
Mailing address
11025 RCA CENTER DR STE 300, PALM BEACH GARDENS, FL 33410-4269
(561) 514-5822
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
ME35872
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME35872
FL
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
ME35872
FL
Other
Enumeration date
02/14/2006
Last updated
03/11/2020
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