Provider Demographics
NPI:1710781109
Name:MANO DE AURA TELEHEALTH
Entity type:Organization
Organization Name:MANO DE AURA TELEHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:SHARIF
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:347-809-0819
Mailing Address - Street 1:308 ROBINWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-8054
Mailing Address - Country:US
Mailing Address - Phone:347-809-0819
Mailing Address - Fax:
Practice Address - Street 1:308 ROBINWOOD LN
Practice Address - Street 2:
Practice Address - City:CLOVER
Practice Address - State:SC
Practice Address - Zip Code:29710-8054
Practice Address - Country:US
Practice Address - Phone:347-809-0819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center