DR. JOHNNA MANTINEO (NPI# 1952371312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952371312 |
| Entity Type | Individual |
| Full Name | DR. JOHNNA MANTINEO |
| Credential | D.O. |
| Practice Address |
5535 S Williamson Blvd Suite 700 Port Orange FL 32128-8311 |
| Mailing Address |
Po Box 730729 Ormond Beach FL 32173-0729 |
| Practice Telephone | 3862316300 |
| Practice Fax Number | 3863226165 |
| Mailing Telephone | 3862316300 |
| Mailing Fax Number | 3863226165 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2012-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS0005684 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
5535 S WILLIAMSON BLVD SUITE 700 |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32128-8311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415670 | Erin Kwiatkowski | Physical Therapist | 5535 S Williamson Blvd, Port Orange, FL 32128-8311 | 2020-10-23 |
| 1932714045 | Alicia Bommarito | Occupational Therapist | 5535 S Williamson Blvd, Port Orange, FL 32128-8311 | 2020-09-15 |
| 1205449717 | Amanda Breitenbach | Speech-Language Pathologist | 5535 S Williamson Blvd, Port Orange, FL 32128-8311 | 2020-08-25 |
| 1619589934 | Emily Ford | Speech-Language Pathologist | 5535 S Williamson Blvd, Port Orange, FL 32128-8311 | 2020-08-18 |
| 1942811237 | Taylor Bruce | Speech-Language Pathologist | 5535 S Williamson Blvd, Port Orange, FL 32128-8311 | 2020-08-11 |
| 1376169706 | Christina Debiasio | Speech-Language Pathologist | 5535 S Williamson Blvd, Port Orange, FL 32128-8311 | 2020-06-22 |
| 1023634425 | Emily Symons | Speech-Language Pathologist | 5535 S Williamson Blvd, Port Orange, FL 32128-8311 | 2020-06-22 |
| 1083251581 | Paige Tschop | Physical Therapist | 5535 S Williamson Blvd, Port Orange, FL 32128-8311 | 2019-12-03 |
| 1205471810 | Sarah Blake | Speech-Language Pathologist | 5535 S Williamson Blvd, Port Orange, FL 32128-8311 | 2019-11-07 |
| 1457902231 | Emily Luther | Speech-Language Pathologist | 5535 S Williamson Blvd, Port Orange, FL 32128-8311 | 2019-09-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487209979 | Encore Hearing Consultants, LLC | Hearing Instrument Specialist | 5889 S. Williamson Blvd, Suite 1409, Port Orange, FL 32128 | 2019-08-02 |
| 1346768835 | T'neill Treherne | Occupational Therapist | 5535 S. Williamson Blvd Suite 774, Port Orange, FL 32128 | 2017-09-05 |
| 1881055440 | Jose Ortiz | Chiropractor | 6315 S Williamson Blvd Apt 132, Port Orange, FL 32128 | 2016-03-10 |
| 1376915132 | Comfortable Care Dental Health Professionals, Pa | Dentist | 5445 S. Williamson Blvd, Port Orange, FL 32128 | 2015-10-20 |
| 1508289570 | Jeffrey Barnes | Physical Therapist | 5535 S. Williamson B;vd, Port Orange, FL 32128 | 2014-01-28 |
| 1881025542 | Rachael Hall | Physical Therapist | 55335 S Williamson Blvd, Suite 774, Port Orange, FL 32128 | 2013-12-06 |
| 1154765840 | Daniel Fleishman | Counselor | 6709 Ferri Circle, Port Orange, FL 32128 | 2013-04-24 |
| 1215282629 | Jeffrey Mclaughlin | Physical Therapist | 5535 S. Williamson Blvd., Ste 774, Port Orange, FL 32128 | 2012-07-23 |
| 1710266812 | Steven Gerald Daniels | Chiropractor | 1807 Creekwater Blvd, Port Orange, FL 32128 | 2011-08-08 |
| 1639489883 | Dr. Michael Hay and Associates, LLC | Optometrist | 5517 S. Williamson Blvd., #310, Port Orange, FL 32128 | 2010-10-20 |
| Find all providers in zip 32128 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134504855 | Metcare of Florida, Inc. | Family Medicine | 3641 Clyde Morris Blvd, Suite 100, Port Orange, FL 32129-2357 | 2015-07-23 |
| 1952637530 | Elizabeth M Daquila | Family Medicine | 851 Dunlawton Ave Ste 102, Port Orange, FL 32127-4234 | 2009-11-02 |
| 1417118100 | Daniel Gregory Gottlieb | Family Medicine | 790 Dunlawton Ave Ste E, Port Orange, FL 32127-4222 | 2008-06-24 |
| 1295925030 | Anunporn Srisawat | Family Medicine | 4554 S Clyde Morris Blvd, Suite 2, Port Orange, FL 32129-5403 | 2007-07-27 |
| 1831263458 | Richard S Mohammed | Family Medicine | 6114 Pheasant Ridge Dr, Port Orange, FL 32128-6984 | 2006-11-17 |
| 1154409431 | Raul L Zimmerman | Family Medicine | 3800 Woodbriar Trl, Port Orange, FL 32129-9626 | 2006-11-02 |
| 1407964141 | David Billmeier | Family Medicine | 5111 S Ridgewood Ave Ste 301, Port Orange, FL 32127-5170 | 2006-08-25 |
| 1497766331 | Wagid Fahim Guirgis | Family Medicine | 3953 S Nova Rd, Port Orange, FL 32127-4910 | 2006-08-09 |
| 1467469700 | Bhadresh I Patel | Family Medicine | 802 Dunlawton Ave, Ste 101, Port Orange, FL 32127 | 2006-08-01 |
| 1043224538 | Michael Morgan Dietch IIi | Family Medicine | 3875 S Nova Rd, Port Orange, FL 32127-4950 | 2006-07-28 |
| Find all providers in PORT ORANGE | ||||
| City | PORT ORANGE |
| Zip Code | 32128 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.