Healthcare Provider Details

I. General information

NPI: 1710893250
Provider Name (Legal Business Name): MANNER HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4715 W LAWN AVE
TAMPA FL
33611-1137
US

IV. Provider business mailing address

4715 W LAWN AVE
TAMPA FL
33611-1137
US

V. Phone/Fax

Practice location:
  • Phone: 904-290-9582
  • Fax:
Mailing address:
  • Phone: 904-290-9582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LAMAR FRANCE DAVIS III
Title or Position: CEO
Credential:
Phone: 904-290-9582