Individual
MS. THERESA LAURA MANTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4930 E LAKE MARY BLVD, SANFORD, FL 32771-5003
(407) 322-8645
Mailing address
4930 E LAKE MARY BLVD, SANFORD, FL 32771-5003
(407) 322-8645
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
ARNP1842852
FL
Other
Enumeration date
03/10/2015
Last updated
02/15/2017
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