Provider Demographics
NPI:1356523633
Name:MANZANO, ALEX JESUS (MD)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:JESUS
Last Name:MANZANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7887 N KENDALL DR STE 215
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7758
Mailing Address - Country:US
Mailing Address - Phone:786-433-2450
Mailing Address - Fax:786-607-3047
Practice Address - Street 1:4302 ALTON RD STE 620
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2876
Practice Address - Country:US
Practice Address - Phone:786-433-2450
Practice Address - Fax:305-413-5934
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2022-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME110062207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine