MEDICARE: DAVID MANDELBLUM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0073551	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093807752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MANDELBLUM MD

Provider Business Mailing Address
First Line	:	3255 FOREST HILL BLVD
Second Line	:	SUITE 103
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5854
Country	:	US
Telephone Number	:	561-964-4577
Fax Number	:

Provider Business Practice Location Address
First Line	:	3255 FOREST HILL BLVD STE 103
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5854
Country	:	US
Telephone Number	:	561-964-4577
Fax Number	:	561-964-7772

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	11/29/2022

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Directions to “ DAVID MANDELBLUM MD” Practice Location

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