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General NPI Number Information
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NPI Number | 1184734808
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Entity Type | Individual
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Provider Name | DIEGO MANTERO
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 3280 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-7252
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Country | US
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Telephone | 305-444-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 5880 COLLINS AVE APT 903
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2201
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Country | US
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Telephone | 305-868-0873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT15204
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License Number State | FL
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