Organization
BASIL MANGRA MD PA
Active
Other names
BASIL AMNGRA MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASIL MANGRA M.D. (MEDICAL DOCTOR)
(954) 484-6440
Entity
Organization
Contact information
Practice address
2518 N STATE ROAD 7, LAUDERDALE LAKES, FL 33313-2777
(954) 484-6440
(954) 484-0337
Mailing address
2518 N STATE ROAD 7, LAUDERDALE LAKES, FL 33313-2777
(954) 484-6440
(954) 484-0337
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/06/2007
Last updated
11/15/2010
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