Provider Demographics
NPI:1790719649
Name:TARTELL & MANDEL MD LLC
Entity Type:Organization
Organization Name:TARTELL & MANDEL MD LLC
Other - Org Name:SOUTH FLORIDA SINUS AND ALLERGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-983-1211
Mailing Address - Street 1:100 NW 82ND AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1834
Mailing Address - Country:US
Mailing Address - Phone:954-983-1211
Mailing Address - Fax:954-983-4407
Practice Address - Street 1:100 NW 82ND AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1834
Practice Address - Country:US
Practice Address - Phone:954-983-1211
Practice Address - Fax:954-983-4407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Multi-Specialty
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherCBSA MEMORIAL HEALTH
FL=========OtherINTERGRATED HEALTH PLANS
FL=========OtherHUMANA
FL=========OtherPHCS
FL=========OtherPHCS