Michelle Mantilla, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8859 Issued in FL

Practice address

4175 W 20TH Ave
Hialeah, FL 33012-5874

Phone

(305) 825-0300

NPI assigned

Sep 18, 2013

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

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1568898807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14132 SW 52ND LN",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330275981",
            "telephone_number": "786-863-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 W 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330125874",
            "telephone_number": "305-825-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTILLA",
        "first_name": "MICHELLE",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Manriquez-Hurtado
• Dailin Manso Acosta
• Laura Manso Alfonso
• Damaris Manso
• Gerardo Manso III, PHARM.D.
• Manuel Franco, MD
• Manuel Perez-Espinosa MD PA
• Manuel Sanchez PA
• Manuel Suarez MD PA
• Joren Manuel, DO

• Clinical Psychologist in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.