Healthcare Provider Details

I. General information

NPI: 1154200376
Provider Name (Legal Business Name): MANAAL ZULFIQAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3282 GREENWALD WAY N
KISSIMMEE FL
34741-0728
US

IV. Provider business mailing address

2846 CARRICKTON CIR
ORLANDO FL
32824-4232
US

V. Phone/Fax

Practice location:
  • Phone: 321-355-3904
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-468198
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: