Individual provider Active NPI

Diego Mantero

  • Physical Therapist
  • Coral Gables, FL
National Provider Identifier
1184734808
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT15204 Issued in FL
Practice address
3280 Ponce de Leon Blvd
Coral Gables, FL 33134-7252
Phone
(305) 444-0909
NPI assigned
Aug 30, 2006
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X PT15204 FL Primary

Addresses

Primary practice location

3280 Ponce de Leon Blvd
Coral Gables, FL 33134-7252

Mailing address

5880 Collins Ave
Apt 903
Miami Beach, FL 33140-2201
Phone (305) 868-0873

Other identifiers 1

IdentifierTypeStateIssuer
PT15204OtherFLLICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250312002971 FL Practitioner - Physical Therapist in Private Practice 8628599156 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics Pta, Inc. Current Accepting new patients
Rehabclinics Pta, Inc. CurrentSince Jan 9, 2025 Accepting new patients
Rehabclinics Pta, Inc. CurrentSince Jan 9, 2025 Accepting new patients

Locations

13645 Biscayne Blvd
North Miami Beach, FL 33181
Phone (305) 949-2700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1184734808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 COLLINS AVE",
            "address_2": "APT 903",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402201",
            "telephone_number": "305-868-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331347252",
            "telephone_number": "305-444-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTERO",
        "first_name": "DIEGO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT15204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "PT15204",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.