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Manatee Memorial

Nurse Practitioner, Family in Bradenton, FL. Organization (NPI-2).

NPI number1013213065
StatusActive
Last updated in NPPESFeb 8, 2011

Details

NPI
1013213065
Entity type
Organization (NPI-2)
Legal business name
Manatee Memorial
Organization subpart
No
Enumeration date
Feb 8, 2011
Last updated
Feb 8, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family9227132FLYes

Practice location

206 2nd St E
Bradenton, FL 34208-1042

Phone 941-745-7419

Mailing address

2811 38th Ave W
Bradenton, FL 34205-3536

Phone 941-751-0559

Authorized official

Erica Marie-Tyne Disanto
Arnp-C
9412323355

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