Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | HSE29937 | FL |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | NJDCATEMP-006415 | NJ |
N | 207YS0123X | Facial Plastic Surgeon | 164419 | AK |
N | 207YS0123X | Facial Plastic Surgeon | EL07031 | NH |
Y | 207YS0123X | Facial Plastic Surgeon | HSE29937 | FL |
NPI | 1851910517 |
---|---|
Provider Name | Dr. Daniel Oswaldo Manrique |
First Address | Davenport, FL 33896-8176 |
Second Address | Davenport, FL 33896-8176 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2020 |
Last Update Date | 18/11/2021 |