Individual provider · Type 1 NPI

Matthew Mansour

Student in an Organized Health Care Education/Training Program · Lakeland, FL

NPI number 1558050799 Active

Practice location

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543

Call (863) 687-1100 Map

Mailing address

19919 Wittenburg
San Antonio, TX 78256-2115

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X11898 (FL)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1558050799

Matthew Mansour's National Provider Identifier is 1558050799, issued on May 3, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Lakeland, FL. The record was last updated on Jun 22, 2026.