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General NPI Number Information
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NPI Number | 1659279404
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Entity Type | Individual
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Provider Name | MICHELLE 5 MANCILLA
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Gender | Female
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Dates
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Enumeration Date | 10/29/2026
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Last Update Date | 10/29/2026
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Provider Practice Location Address
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Address Line | 18651 NW 77TH CT
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City | HIALEAH
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State | FL
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Zip | 33015-5240
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Country | US
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Telephone | 786-805-2528
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Fax |
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Provider Business Mailing Address
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Address Line | 18651 NW 77TH CT
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City | HIALEAH
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State | FL
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Zip | 33015-5240
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Country | US
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Telephone | 786-805-2528
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 163WI0600X
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Taxonomy Name | Infection Control Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #9
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Taxonomy Code | 163WN1003X
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Taxonomy Name | Nutrition Support Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #10
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Taxonomy Code | 163WP0000X
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Taxonomy Name | Pain Management Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #11
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #12
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Taxonomy Code | 163WX0106X
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Taxonomy Name | Occupational Health Registered Nurse
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License Number | RN9654509
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License Number State | FL
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Taxonomy #13
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9654509
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License Number State | FL
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