Doctor Name: | DR. MANUEL M PENA |
NPI Number: | 1518055821 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME42699 |
Business Practice Address: | 6370 Pine Ridge Rd Suite 101 Naples, FL - 341193906 |
Business Phone Number: | 2393487362 |
Business Fax Number: | 2393524999 |
Mailing Address: | 6370 Pine Ridge Rd, Suite 101 NAPLES |
State: | FL |
Postal Code: | 341193906 |
Phone Number: | 2393487362 |
Fax Number: | 2393524999 |
NPI Enumeration Date: | 10/11/2006 |
NPI Last Update Date: | 07/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME42699 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |