1396534020 NPI number — JOVITA MANZON RPH

Table of content: JOVITA MANZON RPH (NPI 1396534020)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396534020 NPI number — JOVITA MANZON RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MANZON
Provider First Name:
JOVITA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROSARIO
Provider Other First Name:
JOVITA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396534020
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6741 ENGLISH GARDEN WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MASON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45040-5740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-407-1252
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7644 VOICE OF AMERICA CENTRE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST CHESTER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45069-2794
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-712-1002
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/30/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  03221522 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)