Provider Demographics
NPI:1578370177
Name:MANZI, SHENIEKA
Entity type:Individual
Prefix:
First Name:SHENIEKA
Middle Name:
Last Name:MANZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 UPPER MANATEE RIVER RD UNIT 124
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-5705
Mailing Address - Country:US
Mailing Address - Phone:727-564-4385
Mailing Address - Fax:
Practice Address - Street 1:1140 UPPER MANATEE RIVER RD UNIT 124
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-5705
Practice Address - Country:US
Practice Address - Phone:727-564-4385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9574526163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse