Individual
DR. MANUEL M PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6370 PINE RIDGE RD, SUITE 101, NAPLES, FL 34119-3906
(239) 348-7362
(239) 352-4999
Mailing address
6370 PINE RIDGE RD, SUITE 101, NAPLES, FL 34119-3906
(239) 348-7362
(239) 352-4999
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME42699
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09251
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/11/2006
Last updated
07/29/2008
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