DEREK MANTLO NPI 1962825182

NPI Information

NPI: 1962825182
Provider Name: DEREK MANTLO
Classification: Contractor - 171W00000X
Entity Type: Individual
Address:
20688 NW 252ND ST
HIGH SPRINGS, FL
ZIP 32643
Phone: (352) 275-1652
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Derek Mantlo is a contractor in High Springs, FL. The provider is 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). Derek Mantlo NPI is 1962825182. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

20688 NW 252ND ST
HIGH SPRINGS, FL
ZIP 32643-419
Phone: (352) 275-1652

The enumeration date for this NPI number is 1/23/2014 and was last updated on 2/10/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171W00000X	Contractor				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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