Healthcare Provider Details

I. General information

NPI: 1346168010
Provider Name (Legal Business Name): ALEXIS MANNS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N CLYDE MORRIS BLVD
DAYTONA BEACH FL
32114-2724
US

IV. Provider business mailing address

140 BROWN PELICAN DR
DAYTONA BEACH FL
32119-1397
US

V. Phone/Fax

Practice location:
  • Phone: 954-826-6971
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberUO11851
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: