MEDICARE: MONEER M. MANSOUR,MD.PA

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1881801140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONEER M. MANSOUR,MD.PA

Provider Business Mailing Address
First Line	:	8787 BRYAN DAIRY RD STE 330
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33777-1260
Country	:	US
Telephone Number	:	727-391-8009
Fax Number	:	727-391-5782

Provider Business Practice Location Address
First Line	:	8787 BRYAN DAIRY RD STE 330
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33777-1260
Country	:	US
Telephone Number	:	727-391-8009
Fax Number	:	727-391-5782

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MARLENE M MANSOUR
Credential	:
Telephone Number	:	727-391-8009

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	08/22/2020

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