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NPI Code Detail

MEDICARE: FELIX AUGUST MANNELLA III

MEDICARE: FELIX AUGUST MANNELLA III
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1346195534
Entity Type Code : Individual
Provider Name (Legal Business Name) : FELIX AUGUST MANNELLA III
Provider Business Mailing Address
First Line : 4484 146TH LN NW
Second Line :
City : ANDOVER
State : MN
Zip : 55304-2807
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 750 HIGHLAND AVE
Second Line :
City : MADISON
State : WI
Zip : 53705-2221
Country : US
Telephone Number : 608-263-5621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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Directions to “ FELIX AUGUST MANNELLA III ” Practice Location

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