Kevin Carlo Montalbo Manalo, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11033209 Issued in FL

Practice address

130 Ridge Center Dr
Davenport, FL 33837-6413

Phone

(866) 234-8534

Fax

(863) 588-7052

NPI assigned

Jun 4, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.carlo.manalo.1@12125.direct.athenahealth.com

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.

• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Frostproof, FL
  • NPI 1467449660
  Medicare reassignment NPD
• Central Florida Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Bartow, FL
  • NPI 1811796469
  NPD
• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lakeland, FL
  • NPI 1386835064
  NPD
• Central Florida Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Winter Haven, FL
  • NPI 1467752998
  NPD (past)
• Central Florida Health Care Inc

  • Multi-Specialty Clinic/Center
  • Wauchula, FL
  • NPI 1811156672
  NPD (past)
• Central Florida Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Bartow, FL
  • NPI 1407615826
  NPD (past)
• Central Florida Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Avon Park, FL
  • NPI 1831232669
  NPD (past)
• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dundee, FL
  • NPI 1063408813
  NPD (past)
• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Avon Park, FL
  • NPI 1063409290
  NPD (past)
• Central Florida Health Care, Inc.

  • Multi-Specialty Clinic/Center
  • Dundee, FL
  • NPI 1720247588
  NPD (past)
• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wauchula, FL
  • NPI 1790116911
  NPD (past)

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1376384164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 5TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814672",
            "telephone_number": "866-234-8534",
            "fax_number": "863-837-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 RIDGE CENTER DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376413",
            "telephone_number": "866-234-8534",
            "fax_number": "863-588-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALO",
        "first_name": "KEVIN CARLO",
        "middle_name": "MONTALBO",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11033209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123332000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Made for Care LLC
• Durga Prasad Maganti, M.D.,
• Gopi Kiran Maharaja, MD
• Llyamarie Maldonado Hernandez, RD
• Samuel Maldonado Torres
• Abhijit Manaswi, MD
• Manaswi'S Orthopedic and Joint Replacement Institute PLLC
• India Mancuso, PA
• Claudio Manubens, M.D.
• Daniel Mar Chong, A.T.C

• Family Nurse Practitioner in Davenport, FL
• Providers in Davenport, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.