Provider Demographics
NPI:1588896559
Name:MASCARENHAS NOBLE, ANJALI MARY (DO)
Entity type:Individual
Prefix:DR
First Name:ANJALI
Middle Name:MARY
Last Name:MASCARENHAS NOBLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2310 NE 32ND CT
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-8179
Mailing Address - Country:US
Mailing Address - Phone:561-392-3788
Mailing Address - Fax:561-392-3785
Practice Address - Street 1:2499 GLADES RD
Practice Address - Street 2:SUITE 305A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7209
Practice Address - Country:US
Practice Address - Phone:561-392-3788
Practice Address - Fax:561-392-3785
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS7767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH28862Medicare UPIN