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General NPI Number Information
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NPI Number | 1215474127
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Entity Type | Individual
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Provider Name | DENISE L MANZO HIS
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Gender | Female
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Dates
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Enumeration Date | 01/30/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 8951 BONITA BEACH RD SE STE 240
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4201
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Country | US
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Telephone | 239-495-2158
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Fax | 239-495-2515
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Provider Business Mailing Address
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Address Line | 215 SHUMAN BLVD STE 401
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City | NAPERVILLE
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State | IL
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Zip | 60563-8458
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Country | US
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Telephone | 630-303-5380
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Fax | 978-313-6824
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS5241
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License Number State | FL
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