Individual
JOSE OSCAR MANTILLA-RIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6501 ARLINGTON EXPRESSWAY, B105#7069, JACKSONVILLE, FL 32211-5779
(904) 201-9110
(757) 432-3134
Mailing address
6501 ARLINGTON EXPRESSWAY, B105#7069, JACKSONVILLE, FL 32211
(904) 201-9110
(757) 432-3134
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC009876
PA
2084P0800X
Psychiatry Physician
Primary
MD477620
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT215100
PA
Other
Enumeration date
08/27/2018
Last updated
01/08/2026
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