Mantis Wellness Center LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MANTIS WELLNESS CENTER LLC

Practice address

Urb Flamingo Terrace A7 Marg 167
Bayamon, PR 00957

Phone

(787) 981-3037

NPI assigned

Mar 18, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Fernando Rodriguez Nieves, BA

Title

Administrador

Phone

(787) 360-9657

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisandra Gonzalez Ramos, PSYD

  • Clinical Psychologist
  • Bayamon, PR
  • NPI 1114264926
  Medicare reassignment NPD

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1972189298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB FLAMINGO TERRACE A7 MARG 167",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00957",
            "telephone_number": "787-981-3037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB FLAMINGO TERRACE A7 MARG 167",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00957",
            "telephone_number": "787-981-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANTIS WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ NIEVES",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "ADMINISTRADOR",
        "authorized_official_telephone_number": "787-360-9657",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Maldonadoo
• Iona Krystin Malinow-Maceo, M.D.
• Endrina Mangual Valladares, MD
• Julio Cesar Mantero Hormazabal, M.D.
• Julio C Mantero Munoz
• Jose Enrique Manuel Figueroa
• Mapa Health Corporation
• Mapa Health Development (rehab hosp)
• Denisse Marcano, PHARMD
• Karla Marcano

• Clinical Psychologist in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.