| Mantis Wellness Center Llc | |
|
Urb Flamingo Terrace A7 Marg 167 Bayamon PR 00957 | |
| (787) 981-3037 | |
| Not Available |
| Full Name | Mantis Wellness Center Llc |
|---|---|
| Speciality | Psychologist |
| Location | Urb Flamingo Terrace A7 Marg 167, Bayamon, Puerto Rico |
| Authorized Official Name and Position | Fernando Rodriguez Nieves (ADMINISTRADOR) |
| Authorized Official Contact | 7873609657 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mantis Wellness Center Llc Urb Flamingo Terrace A7 Marg 167 Bayamon PR 00957 Ph: (787) 981-3037 | Mantis Wellness Center Llc Urb Flamingo Terrace A7 Marg 167 Bayamon PR 00957 Ph: (787) 981-3037 |
| NPI Number | 1972189298 |
|---|---|
| Provider Enumeration Date | 03/18/2021 |
| Last Update Date | 03/18/2021 |
| Certification Date | 02/03/2021 |
| Medicare PECOS PAC ID | 8729480447 |
|---|---|
| Medicare Enrollment ID | O20210716001377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972189298 | NPI | - | NPPES |
| Provider Name | Lisandra Gonzalez-ramos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114264926 PECOS PAC ID: 4082850151 Enrollment ID: I20181207001128 |
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