Provider Demographics
NPI:1316170350
Name:MANALAC, FERNANDO JACINTO JR (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:JACINTO
Last Name:MANALAC
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5597 N DIXIE HWY
Mailing Address - Street 2:HOLY CROSS ORTHOPEDIC INSTITUTE 2ND FL
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3406
Mailing Address - Country:US
Mailing Address - Phone:954-958-4800
Mailing Address - Fax:
Practice Address - Street 1:5597 N DIXIE HWY
Practice Address - Street 2:HOLY CROSS ORTHOPEDIC INSTITUTE 2ND FL
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3406
Practice Address - Country:US
Practice Address - Phone:954-958-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2013-12-18
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Provider Licenses
StateLicense IDTaxonomies
FLME111467207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine