DR. BASIL MANGRA MD
NPI 1114913688
Legal Medicine in Lauderdale Lakes, FL

Q: What is Basil Mangra's NPI number?

The NPI number for Basil Mangra is 1114913688. It was assigned to this individual provider in the NPPES registry on September 21, 2005.

Q: What is Basil Mangra's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Q: When was this NPI record last updated?

The NPPES record for Basil Mangra was last updated on July 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 21, 2005CLIA 10D0943818 · Waiver

3296N STATE ROAD 7, LAUDERDALE LAKES, FL 33319(954) 484-6440(954) 909-5381 Get Directions Write a Review

NPPES record last updated: July 28, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Basil Mangra Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BASIL MANGRA MD (NPI 1114913688) is an individual legal medicine provider in Lauderdale Lakes, Florida, licensed in Florida (ME62781) and active in the NPI registry since September 2005. He holds a CLIA Waiver certificate valid through March 11, 2027.

NPPES Registry Identity

NPI1114913688

Entity TypeIndividualMale

Primary Taxonomy173000000X

Provider Legal NameDR. BASIL MANGRACredential: MD

Location Address3296N STATE ROAD 7Lauderdale Lakes, FL 33319-5615

Mailing Address3296n State Road 7Lauderdale Lakes, FL 33319-5615 · (954) 484-6440 · Fax (954) 909-5381

Phone(954) 484-6440

Fax(954) 909-5381

Sole ProprietorNo

Enumeration DateSeptember 21, 2005

Last NPPES UpdateJuly 28, 2015

✔ NPI 1114913688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLegal MedicineOther Service Providers

Taxonomy Code173000000X

License✔ Licensed in FL · ME62781

Definition

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.

3296N STATE ROAD 7, Lauderdale Lakes, FL 33319

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Other Identifiers 4

Medicaid371342300FL

Medicare PIN18152FL

Medicare UPINF04182

Medicare PIN18152ZFL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0943818

Basil Mangra MD PA Dba Lauderdale Lakes Medical Center · Lauderdale Lakes, FL

Active · expires Mar 11, 2027

CLIA Number10D0943818

Laboratory TypePhysician Office

Certificate Effective DateMarch 12, 2025

Certificate Expiration DateMarch 11, 2027

Laboratory DirectorKaminie Ramauter

Laboratory Phone(954) 484-6440

Laboratory LocationBasil Mangra MD PA Dba Lauderdale Lakes Medical Center4357 North State Road 7, Lauderdale Lakes, FL 33319

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Basil Mangra's NPI number?

The NPI number for Basil Mangra is 1114913688. It was assigned to this individual provider in the NPPES registry on September 21, 2005.

Where is Basil Mangra located?

Basil Mangra practices at 3296N State Road 7, Lauderdale Lakes, FL 33319. The listed phone number is (954) 484-6440.

What is Basil Mangra's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Does Basil Mangra hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0943818) is associated with this NPI, valid through March 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Basil Mangra was last updated on July 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.