Provider Demographics
NPI:1932476801
Name:MANDEL, JILL ALANE (MS, PHARMD)
Entity type:Individual
Prefix:DR
First Name:JILL ALANE
Middle Name:
Last Name:MANDEL
Suffix:
Gender:F
Credentials:MS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18665 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2918
Mailing Address - Country:US
Mailing Address - Phone:305-466-2844
Mailing Address - Fax:305-466-3343
Practice Address - Street 1:18665 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2918
Practice Address - Country:US
Practice Address - Phone:305-466-2844
Practice Address - Fax:305-466-3343
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL46954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist