Provider Demographics
NPI:1801038971
Name:MANCEBO, ROSARIO EMILIA (CNA)
Entity Type:Individual
Prefix:
First Name:ROSARIO
Middle Name:EMILIA
Last Name:MANCEBO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 BRYAN CT
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-6301
Mailing Address - Country:US
Mailing Address - Phone:407-919-8743
Mailing Address - Fax:407-331-9012
Practice Address - Street 1:608 BRYAN CT
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-6301
Practice Address - Country:US
Practice Address - Phone:407-919-8743
Practice Address - Fax:407-331-9012
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA108691376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide