MEDICARE: ALEXANDER MANLEY

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1518794379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER MANLEY

Provider Business Mailing Address
First Line	:	9115 SUNSHINE DR
Second Line	:
City	:	YOUNGSTOWN
State	:	FL
Zip	:	32466-2093
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8317 FRONT BEACH RD
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32407-4885
Country	:	US
Telephone Number	:	850-532-7407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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Directions to “ ALEXANDER MANLEY ” Practice Location

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