Provider Demographics
NPI:1720415722
Name:MANIK HEALING ARTS, LLC
Entity Type:Organization
Organization Name:MANIK HEALING ARTS, LLC
Other - Org Name:MANIK ARTS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:VANESSA
Authorized Official - Last Name:NAVAS
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:407-406-4497
Mailing Address - Street 1:6217 PEREGRINE CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7581
Mailing Address - Country:US
Mailing Address - Phone:407-406-4497
Mailing Address - Fax:407-412-6256
Practice Address - Street 1:2203 HILLCREST ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4905
Practice Address - Country:US
Practice Address - Phone:407-406-4497
Practice Address - Fax:407-412-6256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3261261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center