Provider Demographics
NPI:1851964621
Name:MANCARI, KAYLIN MAREE
Entity type:Individual
Prefix:
First Name:KAYLIN
Middle Name:MAREE
Last Name:MANCARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4204 SIX FORKS RD APT 2106
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6437
Mailing Address - Country:US
Mailing Address - Phone:336-253-5194
Mailing Address - Fax:
Practice Address - Street 1:399 9TH ST N STE 300
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5820
Practice Address - Country:US
Practice Address - Phone:239-624-4299
Practice Address - Fax:239-624-8856
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-13050363A00000X
FLPA9120431363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant