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Individual

DINA MARIE WAGENER MANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6200 SW 73RD ST, SOUTH MIAMI, FL 33143-4679
(786) 662-4000
Mailing address
1917 NE 119TH RD, NORTH MIAMI, FL 33181-3305
(305) 409-6247

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA12156
TX
363A00000X
Physician Assistant
PA9108979
FL
363A00000X
Physician Assistant
Primary
PA9120888
FL

Other

Enumeration date
09/27/2015
Last updated
07/12/2026
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