Kenneth Paul Manselle, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9101437

Practice address

1050 W Carroll St
Kissimmee, FL 34741-1268

Phone

(407) 518-9775

Fax

(407) 518-0094

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417037052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4473 EMERSON PARK DR",
            "address_2": "#101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328396107",
            "telephone_number": "941-961-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W CARROLL ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347411268",
            "telephone_number": "407-518-9775",
            "fax_number": "407-518-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSELLE",
        "first_name": "KENNETH",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": "PA9101437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Manko Guinart, MD
• Ferdinand Christopher Manlio, DO
• Mohammad Ahmad Manna, RPH
• Leny Carolina Manrique Auli
• Gustavo A. Manrique Pico, APRN
• David Mansour, D.M.D.
• Marina Mansour, PHARMD
• Manton Transportation LLC
• Ericka Betania Manukian Martinez
• Boran Mao, MD

• Medical Physician Assistant in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.