ERALENE MANANGAN (NPI# 1720691843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720691843 |
| Entity Type | Individual |
| Full Name | ERALENE MANANGAN |
| Credential | DNP |
| Practice Address |
4205 Belfort Rd Ste 4030 Jacksonville FL 32216-1475 |
| Mailing Address |
4205 Belfort Rd Ste 4015 Jacksonville FL 32216-3623 |
| Practice Telephone | 9043083751 |
| Practice Fax Number | 9043086890 |
| Mailing Telephone | 9044506017 |
| Mailing Fax Number | 9044506041 |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
11008797 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4205 Belfort Rd Ste 4030, Jacksonville, FL 322161475 | 9043083751 | 9043086890 |
| Street Address |
4205 BELFORT RD STE 4030 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-1475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306456025 | Richard Mercer | Nurse Practitioner | 3545 Saint Johns Bluff Rd S Ste 137, Jacksonville, FL 32224-2682 | 2020-08-06 |
| 1467060434 | Rebecca Bertone | Nurse Practitioner | 8540 Turkey Oaks Dr S, Jacksonville, FL 32277-2920 | 2020-07-16 |
| 1861018616 | Octavia J Robertson | Nurse Practitioner | 3562 Boone Park Ave, Jacksonville, FL 32205-8433 | 2020-06-17 |
| 1902428568 | Kimberly J Grant | Nurse Practitioner | 8680 Baymeadows Rd E Apt 1413, Jacksonville, FL 32256-4002 | 2020-05-17 |
| 1447710900 | Shannska Atis | Nurse Practitioner | 580 W 8th St Fl II5, Jacksonville, FL 32209-6533 | 2019-03-21 |
| 1811462237 | Dzenefa Ramic | Nurse Practitioner | 10175 Fortune Pkwy Unit 206, Jacksonville, FL 32256-6748 | 2018-10-11 |
| 1851871024 | Shakhia Grant | Nurse Practitioner | 3636 University Blvd S Ste B, Jacksonville, FL 32216-4223 | 2018-08-17 |
| 1295230845 | Lacey Cawthron | Nurse Practitioner | 8130 Baymeadows Cir W Ste 109, Jacksonville, FL 32256-1837 | 2018-03-27 |
| 1083116107 | Kbn Healthcare, Pllc | Nurse Practitioner | 9471 Baymeadows Rd Ste 3, Jacksonville, FL 32256-7932 | 2018-03-05 |
| 1578092201 | Rachel Dale Hollenbach | Nurse Practitioner | 4217 Baymeadows Rd Ste 2, Jacksonville, FL 32217-4676 | 2017-06-06 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
Please comment or provide details below to improve the information on ERALENE MANANGAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.