Provider Demographics
NPI:1609137561
Name:LIVIA MANNER, ARNP-PA
Entity type:Organization
Organization Name:LIVIA MANNER, ARNP-PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-519-3373
Mailing Address - Street 1:191 NE 30TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033
Mailing Address - Country:US
Mailing Address - Phone:305-519-3373
Mailing Address - Fax:
Practice Address - Street 1:191 NE 30TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-3039
Practice Address - Country:US
Practice Address - Phone:305-519-3373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health