Individual
MERVIN PUNZALAN MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1463 NECTARINE ST, FERNANDINA BEACH, FL 32034-3027
(904) 491-0177
(904) 491-3173
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(904) 491-0177
(904) 491-3173
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME123580
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016615600
—
FL
05
—
102682978
—
PA
Enumeration date
02/15/2007
Last updated
05/15/2025
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