Individual
MICHAEL TIMOTHY CERVANTES MANEJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5301 S CONGRESS AVE, ATLANTIS, FL 33462-1149
(561) 965-7300
Mailing address
1863 SW 173RD AVE, MIRAMAR, FL 33029-5518
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9338690
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11005963
FL
Other
Enumeration date
11/07/2019
Last updated
03/09/2020
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