Basic Information
| Provider Information | |||||||||
| NPI: | 1467436246 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MANSOUR | ||||||||
| FirstName: | ADEL | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8880 ROYAL PALM BLVD STE 105 | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330655727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549839191 | ||||||||
| FaxNumber: | 8662857068 | ||||||||
| Practice Location | |||||||||
| Address1: | 8880 ROYAL PALM BLVD STE 105 | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330655727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549839191 | ||||||||
| FaxNumber: | 8662857068 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2005 | ||||||||
| LastUpdateDate: | 08/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME0075259 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.