MEDICARE: LEE MICHAEL MANDEL 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	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	ME67643	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
12	27456T	OTHER	FL	MEDICARE

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
2	5972804007	OTHER	FL	CIGNA
3	923524	OTHER	FL	FIRST HEALTH PPO
4	35001	OTHER	FL	VISTA OF SOUTH FLORIDA
5	809	OTHER	FL	TOTAL HEALTH CHOICE
6	2103463	OTHER	FL	AETNA
7	26580	OTHER	FL	NEIGHBORHOOD HEALTH
8	650799846	OTHER	FL	BEECHSTREET
9	27456	OTHER	FL	BLUE CROSS BLUE SHIELD
10	650799846	OTHER	FL	SOUTHCARE
11	7541	OTHER	FL	DIMENSIONS
13	650799846	OTHER	FL	PREFERRED HEALTH NETWORK
14	0799828	OTHER	FL	GHI

General Provider Information

NPI Number	:	1851326029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE MICHAEL MANDEL MD

Provider Business Mailing Address
First Line	:	4400 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3514
Country	:	US
Telephone Number	:	954-983-1211
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3514
Country	:	US
Telephone Number	:	954-983-1211
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	02/27/2012

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