NPIMap

Organization Active NPI

Mark and Kambour MD PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Miami Lakes, FL
National Provider Identifier
1407012461
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME35456 Issued in FL
Legal business name
MARK AND KAMBOUR MD PA
Practice address
16250 NW 59TH Ave Ste 201
Miami Lakes, FL 33014-7542
Phone
(866) 825-4422
Fax
(844) 751-9263
NPI assigned
Jul 30, 2008
Last updated
Sep 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Authorized official

Name
Michael Grattendick
Title
Cfo
Phone
(561) 514-5822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X ME35456 FL Primary

Addresses

Primary practice location

16250 NW 59TH Ave Ste 201
Miami Lakes, FL 33014-7542

Mailing address

1355 River Bend Dr
Dallas, TX 75247-4915

National Provider Directory

National Provider Directory
Tax ID family
Mark and Kambour MD PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1407012461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16250 NW 59TH AVE STE 201",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330147542",
            "telephone_number": "866-825-4422",
            "fax_number": "844-751-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK AND KAMBOUR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "GRATTENDICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "561-514-5822"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME35456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.