Individual provider · Type 1 NPI
Penelope Mantilla, SA-C
Surgical Physician Assistant · Medley, FL
NPI number
1215526165
Active
Practice location
10500 NW 74th St Apt 2-102
Medley, FL 33178-2400
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Assistant | 246ZC0007X | None listed |
| Surgical Physician Assistant Primary | 363AS0400X | None listed |
Surgical Physician Assistant: Definition to come...
About NPI 1215526165
Penelope Mantilla, SA-C's National Provider Identifier is 1215526165, issued on Jan 14, 2021. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Medley, FL. The record was last updated on Jan 14, 2021.