Individual provider Active NPI

Manouchka Mildor, APRN

  • Family Nurse Practitioner
  • Wellington, FL
National Provider Identifier
1265211395
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11028111 Issued in FL
Practice address
1037 S State Road 7 Ste 303
Wellington, FL 33414-6140
Phone
(561) 366-4100
Fax
(561) 798-5581
NPI assigned
Sep 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11028111 FL
Family Nurse Practitioner 363LF0000X APRN11028111 FL Primary

Addresses

Primary practice location

1037 S State Road 7 Ste 303
Wellington, FL 33414-6140

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240920000600 MO Practitioner - Nurse Practitioner 3173064995
I20241205001212 FL Practitioner - Nurse Practitioner 3173064995 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11028111FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mind and Wellness Healthcare Services Psychiatric/Mental Health CurrentSince Sep 23, 2024 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Jan 10, 2025 Accepting new patients
Holistic Behavioral Health LLC CurrentSince Aug 1, 2024 Accepting new patients
Elohim Health and Wellness LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

5700 Lake Worth Rd
Ste 209-8
Greenacres, FL 33463
Phone (561) 258-4867

1037 S State Road 7
Ste 303
Wellington, FL 33414

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

1309 N Flagler Dr
Fl Cancer
West Palm Beach, FL 33401

5988 Mid Rivers Mall Dr
Ste 120
Saint Peters, MO 63304
Phone (636) 775-8952

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1265211395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 S STATE ROAD 7 STE 303",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146140",
            "telephone_number": "561-366-4100",
            "fax_number": "561-798-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILDOR",
        "first_name": "MANOUCHKA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-27",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11028111",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11028111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.