Individual
PHILLIP JOSEPH MANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2501 N ORANGE AVE STE 689, ORLANDO, FL 32804-4648
(407) 303-2024
(407) 303-2038
Mailing address
C/O ST MARY'S HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8695
(208) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
ME158787
FL
207RH0003X
Hematology & Oncology Physician
15718
NH
207RH0003X
Hematology & Oncology Physician
6440
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021599
—
VT
05
—
3077332
—
NH
Enumeration date
08/03/2005
Last updated
03/01/2023
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