Provider Demographics
NPI:1497816292
Name:MANISCALCO, MARIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:MANISCALCO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:MANISCALCO-FEICHTL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:700 E COCO PLUM CIR APT 3
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3750
Mailing Address - Country:US
Mailing Address - Phone:954-536-7864
Mailing Address - Fax:
Practice Address - Street 1:4725 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4603
Practice Address - Country:US
Practice Address - Phone:954-542-2775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045529183500000X
FLPS36703183500000X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist