Individual
JENNIFER LEAH MANISCALCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-4288
(728) 767-8804
Mailing address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-4288
(727) 767-8804
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD32477
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010022509
—
VA
05
—
035153400
—
DC
05
—
403025700
—
MD
Enumeration date
10/25/2006
Last updated
11/17/2021
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