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Individual

SANJEEV V. MANIAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12670 WHITEHALL DR, FORT MYERS, FL 33907-3619
(239) 936-3554
(239) 936-8993
Mailing address
12670 WHITEHALL DR, FORT MYERS, FL 33907-3619
(239) 936-3664
(239) 936-8993

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
01053038
IN
2084N0400X
Neurology Physician
Primary
ME132282
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
021302400
FL
05
200306020A
IN
01
90001187
BLUE SHIELD OF IL
IL
01
JA561Z
MEDICARE
FL
Enumeration date
03/28/2006
Last updated
03/17/2018
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