Provider Demographics
NPI:1710917562
Name:MANUEL, EUGENE LLOYD
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:LLOYD
Last Name:MANUEL
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:EUGENE
Other - Middle Name:L
Other - Last Name:MANUEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 9420
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-9420
Mailing Address - Country:US
Mailing Address - Phone:305-731-3462
Mailing Address - Fax:305-434-1641
Practice Address - Street 1:91500 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2547
Practice Address - Country:US
Practice Address - Phone:305-434-3000
Practice Address - Fax:305-434-1641
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0003888207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82355WMedicare ID - Type Unspecified
FLE32216Medicare UPIN