Individual
GUILLERMO MANTILLA CADENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22770 SKYVIEW CIR, BROOKSVILLE, FL 34602-3106
(813) 997-3802
Mailing address
10521 HEARTH RD, SPRING HILL, FL 34608-3714
(813) 997-3802
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME0019346
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05067111000
—
FL
Enumeration date
08/12/2006
Last updated
02/19/2013
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