MEDICARE: DR. DANIEL OSWALDO MANRIQUE MD

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	TPME6512	FL
2	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	30863	NH
3	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	EL07031	NH
4	207YS0123X	Facial Plastic Surgery Physician	21770-875	WI
5	207YS0123X	Facial Plastic Surgery Physician	164419	AK
6	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	83075	CT
7	207YS0123X	Facial Plastic Surgery Physician	HSE29937	FL

General Provider Information

NPI Number	:	1851910517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL OSWALDO MANRIQUE MD

Provider Business Mailing Address
First Line	:	2934 CAMDEN WAY
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-1730
Country	:	US
Telephone Number	:	813-357-4531
Fax Number	:

Provider Business Practice Location Address
First Line	:	8803 FUTURES DR STE 12-205
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-9022
Country	:	US
Telephone Number	:	407-777-9866
Fax Number	:	432-200-4887

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

Provider Enumeration Date	:	04/13/2020
Last Update Date	:	01/06/2026

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