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NPI Code Detail

MEDICARE: JIANEYA MANZANO SUAREZ APRN

MEDICARE: JIANEYA MANZANO SUAREZ APRN
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
1171M00000XCase Manager/Care CoordinatorCBHCMS101021FL
2246ZC0007XSurgical Assistant17-228FL
3363LF0000XFamily Nurse PractitionerF12230035FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508390329
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIANEYA MANZANO SUAREZ APRN
Provider Business Mailing Address
First Line : 5400 PINEHURST DR
Second Line :
City : SPRING HILL
State : FL
Zip : 34606-3833
Country : US
Telephone Number : 352-277-5348
Fax Number : 352-606-2857
Provider Business Practice Location Address
First Line : 7910 W MCNAB RD
Second Line :
City : NORTH LAUDERDALE
State : FL
Zip : 33068-4303
Country : US
Telephone Number : 954-666-9362
Fax Number : 305-402-2800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2017
Last Update Date : 09/24/2024

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