MEDICARE: CHRISTINA MANNING

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	1041C0700X	Clinical Social Worker	17242	FL

General Provider Information

NPI Number	:	1770277857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA MANNING

Provider Business Mailing Address
First Line	:	4190 W 18TH CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-5803
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4190 W 18TH CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-5803
Country	:	US
Telephone Number	:	786-369-6115
Fax Number	:

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

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	06/02/2023

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Directions to “ CHRISTINA MANNING ” Practice Location

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