Provider Demographics
NPI:1871849489
Name:REMOGENE, MANOUSHKA REUNIDE
Entity Type:Individual
Prefix:MS
First Name:MANOUSHKA
Middle Name:REUNIDE
Last Name:REMOGENE
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:PO BOX 641005
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33164-1005
Mailing Address - Country:US
Mailing Address - Phone:954-326-2786
Mailing Address - Fax:
Practice Address - Street 1:20801 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1430
Practice Address - Country:US
Practice Address - Phone:954-326-2786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL120000996OtherFLORIDA LIMITED LIABILITY COMPANY
FL455305927Medicaid