Provider Demographics
NPI:1508828864
Name:MANIQUIS, ELLIS RAMIREZ (PT)
Entity Type:Individual
Prefix:MR
First Name:ELLIS
Middle Name:RAMIREZ
Last Name:MANIQUIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:ELLIS
Other - Middle Name:FAUSTINO RAMIREZ
Other - Last Name:MANIQUIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:6224 LANSDOWNE CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-5105
Mailing Address - Country:US
Mailing Address - Phone:561-732-2916
Mailing Address - Fax:
Practice Address - Street 1:6200 W ATLANTIC AVE
Practice Address - Street 2:#201
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-3506
Practice Address - Country:US
Practice Address - Phone:561-499-3041
Practice Address - Fax:561-499-3042
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7306225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist