Organization
NATURE COAST SURGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ANTHONY MANUBAY M.D. (PRESIDENT)
(352) 596-5919
Entity
Organization
Contact information
Practice address
11343 CORTEZ BLVD, BROOKSVILLE, FL 34613-5404
(352) 596-5919
(352) 596-5918
Mailing address
11343 CORTEZ BLVD, BROOKSVILLE, FL 34613-5404
(352) 596-5919
(352) 596-5918
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
ME 75741
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00889
UNIVERSAL
FL
01
—
217051
WELLCARE
FL
01
—
241641
AVMED
FL
05
—
255398800
—
FL
01
—
3668439
AETNA
FL
01
—
44931
BLUE CROSS BLUE SHIELD FL
FL
01
—
59020000449310
BC BS NATL ACCT
FL
Enumeration date
10/18/2006
Last updated
06/06/2014
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