Healthcare Provider Details

I. General information

NPI: 1801037833
Provider Name (Legal Business Name): MELODY MANHIRE MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2009
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 DHARMA CIR
WINTER GARDEN FL
34787-4368
US

IV. Provider business mailing address

636 DHARMA CIR
WINTER GARDEN FL
34787-4368
US

V. Phone/Fax

Practice location:
  • Phone: 407-619-9608
  • Fax:
Mailing address:
  • Phone: 407-619-9608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 9284362
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11031088
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: