NPIMap

Organization Active NPI

Lauderdale Lakes Medical Center Inc

  • Internal Medicine Physician
  • Lauderdale Lakes, FL
National Provider Identifier
1194008631
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LAUDERDALE LAKES MEDICAL CENTER INC
Practice address
2518 N State Road 7
Lauderdale Lakes, FL 33313-2777
Phone
(954) 484-6440
NPI assigned
Sep 21, 2011
Last updated
Sep 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Basil Mangra, MDNPI 1114913688
Title
Owner
Phone
(954) 484-6440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

2518 N State Road 7
Lauderdale Lakes, FL 33313-2777

Mailing address

2518 N State Road 7
Lauderdale Lakes, FL 33313-2777
Phone (954) 484-6440

National Provider Directory

National Provider Directory
Tax ID family
Lauderdale Lakes Medical Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1194008631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 N STATE ROAD 7",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333132777",
            "telephone_number": "954-484-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 N STATE ROAD 7",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333132777",
            "telephone_number": "954-484-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUDERDALE LAKES MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "MANGRA",
        "authorized_official_first_name": "BASIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-484-6440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.