Selina Therese Mantanona, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070018813 Issued in IL

Practice address

928 Mar Walt Dr
Suite #103
Fort Walton Beach, FL 32547-6706

Phone

(850) 863-7580

Fax

(850) 863-7549

NPI assigned

Aug 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Fort Walton Beach Medical Center, Inc.

  • General Acute Care Hospital
  • Ft Walton Beach, FL
  • NPI 1639128820
  NPD (past)
• Premier Rehab Management, LLC

  • Physical Therapist
  • Navarre, FL
  • NPI 1821014390
  NPD (past)

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1508113382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 MAR WALT DR",
            "address_2": "SUITE #103",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476706",
            "telephone_number": "850-863-7580",
            "fax_number": "850-863-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 MAR WALT DR",
            "address_2": "SUITE #103",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476706",
            "telephone_number": "850-863-7580",
            "fax_number": "850-863-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTANONA",
        "first_name": "SELINA",
        "middle_name": "THERESE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Ann Mahnken, MS, OTR/L
• Cavan Mair
• Jennifer R Maloy, APRN
• Lindsey Alaina Mann-Badyrka, APRN
• Irvin Randolph Manning, MD
• Rose Ann Quilang Maquinad, BSN,RN
• Mar-Walt Drive Emergency Physicians, LLC
• Maranatha Transportation Services
• Maria Elen P Gajo MD PA
• Marianne C.McAuliffe,LCSW,PL

• Physical Therapist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.