Provider Demographics
NPI:1821095829
Name:PENALVER, MANUEL A (MD)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:A
Last Name:PENALVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 UNIVERSITY DR
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2008
Mailing Address - Country:US
Mailing Address - Phone:305-663-7001
Mailing Address - Fax:305-663-7004
Practice Address - Street 1:5000 UNIVERSITY DR
Practice Address - Street 2:SUITE 3300
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2008
Practice Address - Country:US
Practice Address - Phone:305-663-7001
Practice Address - Fax:305-663-7004
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0032935207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4971652-004OtherCIGNA HMO PROVIDER #
FL96471OtherBCBS OF FL PROVIDER #
FL139058OtherUSA MNGD. CR. PROV. #
FL1998955OtherFIRST HEALTH PROVIDER #
FL7799949OtherGHI PROVIDER NUMBER
FL068968800Medicaid
FL209886OtherAVMED THRU PARITY PROV. #
FL000021064-WOtherHUMANA PROVIDER #
FL197036OtherWELLCARE PROVIDER NUMBER
FL4603OtherTOTAL HLTH. CH. PROV. #
FL4971652-00OtherCIGNA PPO PROVIDER #
FL50440OtherNEIGHBORHOOD PROV. #
FL5599101OtherAETNA PROVIDER NUMBER
FLE32344OtherVISTA PROVIDER NUMBER
FL209886OtherAVMED THRU PARITY PROV. #
FL4971652-00OtherCIGNA PPO PROVIDER #