Provider Demographics
NPI:1992925846
Name:MANDAL, ANITA (MD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:MANDAL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2401 PGA BLVD
Mailing Address - Street 2:SUITE 146
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3590
Mailing Address - Country:US
Mailing Address - Phone:561-238-0040
Mailing Address - Fax:561-238-0041
Practice Address - Street 1:2401 PGA BLVD
Practice Address - Street 2:SUITE 146
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3590
Practice Address - Country:US
Practice Address - Phone:561-238-0040
Practice Address - Fax:561-238-0041
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2010-07-20
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Provider Licenses
StateLicense IDTaxonomies
FLME91982082S0099X, 207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery