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General NPI Number Information
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NPI Number | 1508390329
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Entity Type | Individual
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Provider Name | JIANEYA MANZANO SUAREZ APRN
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Gender | Female
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 7910 W MCNAB RD
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068-4303
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Country | US
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Telephone | 954-666-9362
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Fax | 305-402-2800
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Provider Business Mailing Address
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Address Line | 5400 PINEHURST DR
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City | SPRING HILL
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State | FL
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Zip | 34606-3833
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Country | US
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Telephone | 352-277-5348
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Fax | 352-606-2857
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CBHCMS101021
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 17-228
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F12230035
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License Number State | FL
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