Individual
VIVEK M MANIKAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1093 A1A BEACH BLVD PMB415, ST AUGUSTINE, FL 32080
(904) 819-9925
(904) 819-9926
Mailing address
100 WHETSTONE PL STE 205, ST AUGUSTINE, FL 32086-5775
(904) 819-9925
(904) 819-9926
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME 0080064
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259185500
—
FL
01
—
35271
BCBS
FL
Enumeration date
06/20/2007
Last updated
12/02/2014
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