Mangra, Basil

Mangra, Basil is an individual health care provider with primary practice located at 3296N State Road 7 , Lauderdale Lakes FL 33319-5615. He recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as his primary health care specialty. Mangra, Basil can be contacted via phone (954) 484-6440.

Contact Information

Primary practice address
3296N State Road 7 Lauderdale Lakes FL 33319-5615
Phone: (954) 484-6440
Fax: (954) 909-5381
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X ME62781 Florida

Profile Details

NPI number 1114913688
LBN Legal business name Mangra, Basil
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated Jul 28th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114913688 NPPES
Florida MEDICAID 371342300

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