Organization
PMMDOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER MICHAEL MANIS M.D. (PRESIDENT)
(850) 478-0240
Entity
Organization
Contact information
Practice address
6435 DUNLIETH PLACE, PENSACOLA, FL 32504-7887
(850) 478-0240
(850) 478-0502
Mailing address
6435 DUNLIETH PLACE, PENSACOLA, FL 32504-7887
(850) 478-0240
(850) 478-0502
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
ME38433
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042767500
—
FL
Enumeration date
12/01/2008
Last updated
04/30/2010
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