Individual
ALICE BERTHA MANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1805 HOBBS RD, AUBURNDALE, FL 33823-4644
(863) 965-5400
(863) 965-3739
Mailing address
1290 GOLFVIEW AVE, 4TH FLOOR ATTN BILLING DEPARTMENT, BARTOW, FL 33830-6738
(863) 519-7900
(863) 519-7696
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP127374
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034043000
—
FL
Enumeration date
10/10/2005
Last updated
08/11/2010
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