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General NPI Number Information
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NPI Number | 1881021467
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Entity Type | Individual
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Provider Name | MANOUCHEKA CADET APRN
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Gender | Female
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Dates
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Enumeration Date | 09/27/2013
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 2828 S MCCALL RD STE 21
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City | ENGLEWOOD
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State | FL
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Zip | 34224-9517
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Country | US
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Telephone | 941-290-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 13436 BOUVARDIA LN
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City | PORT CHARLOTTE
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State | FL
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Zip | 33981-3944
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Country | US
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Telephone | 845-803-5162
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 314634
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11036324
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License Number State | FL
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