Basic Information
| Provider Information | |||||||||
| NPI: | 1760784870 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADEL S MANSOUR MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3250 SAINT CHARLES PL | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334345307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619881777 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5352 LINTON BLVD | ||||||||
| Address2: | |||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334846514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614984440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2010 | ||||||||
| LastUpdateDate: | 11/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | MANSOUR | ||||||||
| AuthorizedOfficialFirstName: | ADEL | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5619881777 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.