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NPI Code Detail

MEDICARE: DR. GISELL MANSUR MD

MEDICARE: DR. GISELL MANSUR 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
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine PhysicianME142680FL

Other Identifiers

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

General Provider Information

NPI Number : 1053833137
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GISELL MANSUR MD
Provider Business Mailing Address
First Line : 7944 SW 195TH TER
Second Line :
City : CUTLER BAY
State : FL
Zip : 33157-8129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 836 PONCE DE LEON BLVD STE 204
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-3068
Country : US
Telephone Number : 305-441-0910
Fax Number : 305-441-0920
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2017
Last Update Date : 10/23/2023

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Directions to “ DR. GISELL MANSUR MD” Practice Location

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