DR. BASIL MANGRA MD NPI 1114913688

NPI Information

  • NPI: 1114913688
  • Provider Name: DR. BASIL MANGRA, MD
  • Classification: Legal Medicine - 173000000X
  • Entity Type: Individual
  • CLIA Number: 10D0943818
  • Address: 3296N STATE ROAD 7
    LAUDERDALE LAKES, FL
    ZIP 33319
  • Phone: (954) 484-6440

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NPI Details

DR. Basil Mangra, MD is a legal medicine in Lauderdale Lakes, FL. The provider is the specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. DR. Basil Mangra, MD NPI is 1114913688. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3296N STATE ROAD 7
LAUDERDALE LAKES, FL
ZIP 33319-615
Phone: (954) 484-6440
Fax: (954) 909-5381

The CLIA number assigned to this NPI record is 10D0943818 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/21/2005 and was last updated on 7/28/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1173000000XLegal MedicineME62781FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1371342300MEDICAIDFLORIDA
218152MEDICARE PINFLORIDA
3F04182MEDICARE UPIN
418152ZMEDICARE PINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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