# MANTA MEDICAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306147160
- **Authorized official:** MR. DIEGO JOSE LOINAZ (PRESIDENT)
- **Authorized official phone:** (787) 294-5551

## Contact information

- **Practice address:** 1883 CALLE GLASGOW, SAN JUAN, PR 00921-4820
- **Practice address phone:** (787) 294-5551
- **Mailing address:** 1353 AVE LUIS VIGOREAUX, PMB 486, GUAYNABO, PR 00966-2715
- **Mailing address phone:** (787) 294-5551

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 11/10/2010
- **Last updated:** 10/01/2015