Healthcare Provider Details

I. General information

NPI: 1487628251
Provider Name (Legal Business Name): DAVID L MANDELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10150 HAGEN RANCH ROAD SUITE 100
BOYNTON BEACH FL
33437
US

IV. Provider business mailing address

15280 NW 79TH CT STE 200
MIAMI LAKES FL
33016-5873
US

V. Phone/Fax

Practice location:
  • Phone: 561-736-8141
  • Fax: 561-736-5662
Mailing address:
  • Phone: 305-558-3724
  • Fax: 786-907-4485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberME102591
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: