| Doctor Name: | MR. ERNESTO RAUL MANZANO-MACEIRA |
| NPI Number: | 1366682718 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | |
| Business Practice Address: | 2150 W 68th St #200 Hialeah, FL - 330161802 |
| Business Phone Number: | 3058272977 |
| Business Fax Number: | 3058206371 |
| Mailing Address: | 1000 Park Centre Blvd, Suite 136 MIAMI |
| State: | FL |
| Postal Code: | 331695373 |
| Phone Number: | 3056210023 |
| Fax Number: | 3056500674 |
| NPI Enumeration Date: | 02/25/2009 |
| NPI Last Update Date: | 09/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |