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Organization
MANATEE MEMORIAL
Active
Organization
MANATEE MEMORIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERICA MARIE-TYNE DISANTO (ARNP-C)
(941) 232-3355
Entity
Organization
Contact information
Practice address
206 2ND ST E, BRADENTON, FL 34208-1042
(941) 745-7419
Mailing address
2811 38TH AVE W, BRADENTON, FL 34205-3536
(941) 751-0559
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9227132
FL
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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