Provider Demographics
NPI:1548420656
Name:MERCEDES Z. MANNING OD P A
Entity type:Organization
Organization Name:MERCEDES Z. MANNING OD P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:ZELINDA
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-798-5910
Mailing Address - Street 1:8920 SW 159TH TER
Mailing Address - Street 2:
Mailing Address - City:VILLAGE OF PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1900
Mailing Address - Country:US
Mailing Address - Phone:305-669-1501
Mailing Address - Fax:305-669-1262
Practice Address - Street 1:7299 DADELAND MALL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7853
Practice Address - Country:US
Practice Address - Phone:305-669-1501
Practice Address - Fax:305-669-1262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3658152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL621141100Medicaid