Provider Demographics
NPI:1356334007
Name:MANIAR, GIGI (MD)
Entity Type:Individual
Prefix:MRS
First Name:GIGI
Middle Name:
Last Name:MANIAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 CITRUS TOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6803
Mailing Address - Country:US
Mailing Address - Phone:352-242-1500
Mailing Address - Fax:352-242-0053
Practice Address - Street 1:6012 ALOMA WOODS BLVD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9786
Practice Address - Country:US
Practice Address - Phone:407-366-7455
Practice Address - Fax:407-359-8410
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90801208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270238000Medicaid
FL270238000Medicaid