Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BASIL MANGRA, MD
DeactivatedDR. BASIL MANGRA, MD is a Legal Medicine healthcare provider located in LAUDERDALE LAKES, Florida. NPI 1114913688 is deactivated in the NPPES registry. Verify at CMS.
Legal Medicine · LAUDERDALE LAKES, FL
This NPI has been deactivated.
The record was deactivated on March 24, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1114913688
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 21, 2005 (0.5041095890411 yrs)
- Last Updated
- Jul 28, 2015
- Deactivated
- Mar 24, 2006
- License
-
ME62781 (FL)
Practice Information
- Address
-
3296N STATE ROAD 7LAUDERDALE LAKES, FL, 333195615Browse FL providers · Browse ZIP 33319
- Phone
- 9544846440
- Fax
- 9549095381
- Primary Specialty
-
Legal Medicine
173000000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.