FABIAN MANTILLA DO
NPI 1083547582
Student in an Organized Health Care Education/Training Program in Orlando, FL

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since June 04, 2026PECOS Enrolled

7727 LAKE UNDERHILL RD, ORLANDO, FL 32822(407) 303-8110 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Fabian Mantilla Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FABIAN MANTILLA DO (NPI 1083547582) is an individual student in an organized health care education/training program in Orlando, Florida, licensed in Florida (UO11497) and active in the NPI registry since June 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083547582

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameFABIAN MANTILLACredential: DO

Location Address7727 LAKE UNDERHILL RDOrlando, FL 32822-8224

Mailing Address2501 N Orange Ave Ste 235Orlando, FL 32804-4659 · (201) 354-8986

Phone(407) 303-8110

Sole ProprietorNo

Enumeration DateJune 4, 2026

NPPES CertifiedJune 4, 2026

✔ NPI 1083547582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in FL · UO11497

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

7727 LAKE UNDERHILL RD, Orlando, FL 32822

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fabian Mantilla Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.