Individual provider Active NPI

Carlos Mantaras

  • Chiropractor
  • Miami, FL
National Provider Identifier
1679338347
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14325 Issued in FL
Practice address
12093 SW 152ND St
Miami, FL 33177-1607
Phone
(786) 646-0098
NPI assigned
Feb 20, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH14325 FL Primary

Addresses

Primary practice location

12093 SW 152ND St
Miami, FL 33177-1607

Mailing address

7825 NW 107TH Ave Apt 509
Doral, FL 33178-4437
Phone (787) 617-1769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH14325FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New Leaf Chiropractic Inc Chiropractor CurrentSince Feb 25, 2024 Accepting new patients

Locations

12093 SW 152nd St
Miami, FL 33177
Phone (786) 646-0098

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1679338347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 NW 107TH AVE APT 509",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331784437",
            "telephone_number": "787-617-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12093 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771607",
            "telephone_number": "786-646-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTARAS",
        "first_name": "CARLOS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.