Provider Demographics
NPI:1851170336
Name:MANZANERO, CENIS M
Entity Type:Individual
Prefix:
First Name:CENIS
Middle Name:M
Last Name:MANZANERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 CASON COVE DR APT 1312
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-6660
Mailing Address - Country:US
Mailing Address - Phone:786-641-4383
Mailing Address - Fax:
Practice Address - Street 1:4625 CASON COVE DR APT 1312
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-6660
Practice Address - Country:US
Practice Address - Phone:786-641-4383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker