Active NPI
Mirisa Mancano
- Registered Nurse
- North Fort Myers, FL
National Provider Identifier
1568367928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 9556270
- Practice address
- 2604 Table Coral TRL
North Fort Myers, FL 33903-1493 - Phone
- (708) 400-4465
- NPI assigned
- Oct 13, 2026
- Last updated
- Oct 13, 2026
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 9556270 | FL | Primary |
Addresses
Primary practice location
2604 Table Coral TRL
North Fort Myers, FL 33903-1493
Mailing address
2604 Table Coral TRL
North Fort Myers, FL 33903-1493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791849600000",
"number": "1568367928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2604 TABLE CORAL TRL",
"city": "NORTH FORT MYERS",
"state": "FL",
"postal_code": "339031493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2604 TABLE CORAL TRL",
"city": "NORTH FORT MYERS",
"state": "FL",
"postal_code": "339031493",
"telephone_number": "708-400-4465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCANO",
"first_name": "MIRISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-10-13",
"last_updated": "2026-10-13",
"certification_date": "2026-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "9556270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.