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General NPI Number Information
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NPI Number | 1740764257
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Entity Type | Individual
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Provider Name | DANIEL ALEX MANNING APRN
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Gender | Male
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 3605 MADACA LN
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City | TAMPA
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State | FL
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Zip | 33618-2048
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Country | US
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Telephone | 813-777-1641
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Fax |
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Provider Business Mailing Address
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Address Line | 8924 SOUTHBAY DR
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City | TAMPA
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State | FL
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Zip | 33615-2770
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Country | US
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Telephone | 904-553-1218
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11000190
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN11000190
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License Number State | FL
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