DEREK MANTLO (NPI# 1962825182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962825182 |
| Entity Type | Individual |
| Full Name | DEREK MANTLO |
| Practice Address |
20688 Nw 252nd St High Springs FL 32643-8419 |
| Mailing Address |
Po Box 793 Alachua FL 32616-0793 |
| Practice Telephone | 3522751652 |
| Mailing Telephone | 3522751652 |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2014-02-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | Other Service Providers |
| Street Address |
20688 NW 252ND ST |
| City | HIGH SPRINGS |
| State | FL |
| Zip Code | 32643-8419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003375726 | Bahman Sahranavard Sr. | Counselor | Rania Main St., Rania, SOLAYMAIA 32643 | 2019-03-13 |
| 1396224036 | Roszina Williams | Nurse's Aide | 18998 Nw 253 Street, High Springs, FL 32643 | 2018-08-13 |
| 1760700637 | High Springs Pediatrics LLC | Pediatrics | 210 Nw 1st Avenue, High Springs, FL 32643 | 2010-05-17 |
| 1306094800 | Cox & Hanley Dmd Plc | Dentist | 23321 N. W. Cr 236, High Springs, FL 32643 | 2008-09-09 |
| 1013119940 | Gene H. Petteway | Pharmacist | 1080 N W Santa Fe Blvd, High Sprngs, FL 32643 | 2007-06-04 |
| 1538381363 | Ian C Dennis | Dentist | 60 South Main Street, High Springs, FL 32643 | 2007-05-02 |
| 1831231000 | Craig Gardner | Massage Therapist | 220 Nw 4th St, High Springs, FL 32643 | 2007-02-13 |
| 1689722779 | Nancy L Linkous | Massage Therapist | 425 Ne Santa Fe Blvd., High Springs, FL 32643 | 2007-01-08 |
| 1356362651 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 20303 N Us Hwy 441, High Springs, FL 32643 | 2006-07-21 |
| 1417901125 | Sheryl Marie Heath | Nurse Practitioner | 9513 Nw Sr 45, High Springs, FL 32643 | 2006-05-19 |
| Find all providers in zip 32643 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376810762 | Marita Guilderson | Contractor | 14253 Nw 232nd St, High Springs, FL 32643-6855 | 2011-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183683 | Ana Cecilia Fonseca | Contractor | 3456 Sw 112th Ave, Miami, FL 33165-3456 | 2020-10-29 |
| 1477151884 | Joel Laurenceau | Contractor | 2561 Sw Grotto Cir, Port Saint Lucie, FL 34953-2927 | 2020-10-16 |
| 1649878208 | Jill K Bailey | Contractor | 1809 E Broadway St Ste 147, Oviedo, FL 32765-8597 | 2020-10-15 |
| 1700484771 | James Butler | Contractor | 7771 W Oakland Park Blvd Ste 105c, Sunrise, FL 33351-6749 | 2020-10-13 |
| 1407453277 | Princess Laqa Callahan | Contractor | 2620 Nw 19th St, Ft Lauderdale, FL 33311-3324 | 2020-10-05 |
| 1154928158 | Amy Benzenhafer | Contractor | 586 Woodlow Rd, Niceville, FL 32578-2108 | 2020-10-03 |
| 1083220297 | Melissa Velez | Contractor | 104 Sw Peacock Blvd Apt 3-205, Port St Lucie, FL 34986-3467 | 2020-09-22 |
| 1023623626 | Floridamed Health Network | Contractor | 1806 N Flamingo Rd Ste 220, Pembroke Pines, FL 33028-1030 | 2020-09-10 |
| 1700491677 | Patrice Alicia Leys | Contractor | 2022 Nw 43rd Ter Apt 6, Lauderhill, FL 33313-4340 | 2020-09-09 |
| 1407468366 | Platinum Choice Healthcare | Contractor | 1489 W Palmetto Park Rd Ste 512, Boca Raton, FL 33486-3326 | 2020-08-20 |
| Find all providers with the same taxonomy | ||||
| City | HIGH SPRINGS |
| Zip Code | 32643 |
Please comment or provide details below to improve the information on DEREK MANTLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.