Provider Demographics
NPI:1538333125
Name:ALAN H. MANDELL P.A.
Entity Type:Organization
Organization Name:ALAN H. MANDELL P.A.
Other - Org Name:MANDELL CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MANDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-654-9100
Mailing Address - Street 1:20334 NW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2503
Mailing Address - Country:US
Mailing Address - Phone:305-654-9100
Mailing Address - Fax:
Practice Address - Street 1:20334 NW 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-2503
Practice Address - Country:US
Practice Address - Phone:305-654-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
39941OtherMEDICARE GROUP
FL380103900Medicaid