Mantlo, Derek

Mantlo, Derek is an individual health care provider with primary practice located at 20688 Nw 252Nd St , High Springs FL 32643-8419. He recently has only one registered license in Other Service Providers / Contractor, which is considered as his primary health care specialty. Mantlo, Derek can be contacted via phone (352) 275-1652.

Contact Information

Primary practice address
20688 Nw 252Nd St High Springs FL 32643-8419
Phone: (352) 275-1652
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X

Profile Details

NPI number 1962825182
LBN Legal business name Mantlo, Derek
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2014
Last updated Feb 10th, 2014 - about 11 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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