Provider Demographics
NPI:1073515953
Name:MANHOFF, HOWARD ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:ALAN
Last Name:MANHOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3120
Mailing Address - Country:US
Mailing Address - Phone:727-501-7287
Mailing Address - Fax:727-559-0594
Practice Address - Street 1:1301 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3120
Practice Address - Country:US
Practice Address - Phone:727-501-7287
Practice Address - Fax:727-559-0594
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME605702085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14904OtherBLUE CROSS BLUE SHIELD
FL370229400Medicaid
FL1038517OtherCAREPLUS
FL1667293OtherUNITED HEALTHCARE
FL329569OtherAVMED
FL370229400Medicaid
B83060Medicare UPIN