JUAN A MANTILLA MD PA
Osteopathic Medicine in Miami, FL

License number
Florida ME77038
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: DR. JUAN ALBERTO MANTILLA M.D.
Title: PRESIDENT
Phone: (305) 279-4222
Address
Address
8501 SW Sw 124 Ave Suite: 202, Miami, FL 33183
National Provider ID: 1962732388
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Juan A. Mantilla, M.D., PA

Miami, FL

Registration:
Nov 4, 2002
Addresses:
11050 N Kendall Dr, Miami, FL 33176
8501 SW 124 Ave, Miami, FL 33183
State ID:
P02000118834
Business type:
Domestic for Profit Corporation
President, Treasurer, Director, Secretary:
Juan A. Mantilla (President, Treasurer, Director, Secretary)
Agent:
Steven K. Baird

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