Provider Demographics
NPI:1437552338
Name:MANN, MICHAEL JEFFREY
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JEFFREY
Last Name:MANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 2ND ST LOT 36
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-5975
Mailing Address - Country:US
Mailing Address - Phone:207-432-4545
Mailing Address - Fax:
Practice Address - Street 1:1205 4TH ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3707
Practice Address - Country:US
Practice Address - Phone:305-434-7660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator