Active NPI
Anthony Manzolillo
- Behavior Analyst
- Port Orange, FL
National Provider Identifier
1356618763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 6105 Delmar Dr
Port Orange, FL 32127-6743 - Phone
- (386) 882-5412
- NPI assigned
- Nov 30, 2011
- Last updated
- Nov 30, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | NU | Primary |
Addresses
Primary practice location
6105 Delmar Dr
Port Orange, FL 32127-6743
Mailing address
6105 Delmar Dr
Port Orange, FL 32127-6743
Phone (386) 882-5412
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322611200000",
"number": "1356618763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6105 DELMAR DR",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321276743",
"telephone_number": "386-882-5412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6105 DELMAR DR",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321276743",
"telephone_number": "386-882-5412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZOLILLO",
"first_name": "ANTHONY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-30",
"last_updated": "2011-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.