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PENELOPE MANTILLA SA-C
NPI 1215526165
Physician Assistant - Surgical in Medley, FL

Active since January 14, 2021
10500 NW 74TH ST APT 2-102, MEDLEY, FL 33178(312) 672-2209 Get Directions Write a Review

NPPES record last updated: January 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Penelope Mantilla Sa-c NPPES

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

PENELOPE MANTILLA SA-C (NPI 1215526165) is an individual surgical provider in Medley, Florida and active in the NPI registry since January 2021.

NPPES Registry Identity

NPI1215526165
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NamePENELOPE MANTILLACredential: SA-C
Location Address10500 NW 74TH ST APT 2-102Medley, FL 33178-2400
Mailing Address10500 Nw 74th St Apt 2-102Medley, FL 33178-2400 · (312) 672-2209
Phone(312) 672-2209
Sole ProprietorYes
Enumeration DateJanuary 14, 2021
NPPES CertifiedJanuary 14, 2021
✔ NPI 1215526165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
Also ListedSpecialist/Technologist, Other · Surgical AssistantTaxonomy 246ZC0007X
10500 NW 74TH ST APT 2-102, Medley, FL 33178
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Penelope Mantilla's NPI number?

The NPI number for Penelope Mantilla is 1215526165. It was assigned to this individual provider in the NPPES registry on January 14, 2021.

Where is Penelope Mantilla located?

Penelope Mantilla practices at 10500 NW 74th St Apt 2-102, Medley, FL 33178. The listed phone number is (312) 672-2209.

What is Penelope Mantilla's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Penelope Mantilla was last updated on January 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.