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General NPI Number Information
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NPI Number | 1568520971
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Entity Type | Individual
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Provider Name | NELSON MANE MD, DC
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 2901 W SAINT ISABEL ST STE F
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City | TAMPA
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State | FL
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Zip | 33607-6371
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Country | US
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Telephone | 813-935-4744
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Fax | 813-931-1427
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Provider Business Mailing Address
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Address Line | 16124 BELLE MEADE BLVD
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City | ODESSA
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State | FL
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Zip | 33556-3308
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Country | US
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Telephone | 813-935-4744
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH4968
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME137501
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License Number State | FL
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