Mantecon, Israel Juan

Mantecon, Israel Juan is an individual health care provider with primary practice located at 1723 Lucerne Ter Ste 100 , Orlando FL 32806-2916. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Nuclear Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Mantecon, Israel Juan can be contacted via phone (407) 738-4200.

Contact Information

Primary practice address
1723 Lucerne Ter Ste 100 Orlando FL 32806-2916
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X ME54748 Florida
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X ME54748 Florida

Profile Details

NPI number 1295739241
LBN Legal business name Mantecon, Israel Juan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2005
Last updated Nov 28th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295739241 NPPES
Florida MEDICAID 374977100
Florida Other ME54748

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