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JUAN A MANTILLA MD PA
NPI 1962732388
Internal Medicine in Miami, FL

Active since January 07, 2010CLIA 10D1008941 · Waiver
11400 N KENDALL DR STE 204, MIAMI, FL 33176(305) 279-2222(305) 501-2031 Get Directions Write a Review

NPPES record last updated: June 29, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Juan A Mantilla Md Pa NPPES

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

JUAN A MANTILLA MD PA (NPI 1962732388) is a healthcare organization registered as an internal medicine in Miami, Florida and active in the NPI registry since January 2010. The organization holds a CLIA Waiver certificate valid through February 2, 2027 and lists Juan Alberto Mantilla, President, as its authorized official.

NPPES Registry Identity

NPI1962732388
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameJUAN A MANTILLA MD PA
Location Address11400 N KENDALL DR STE 204Miami, FL 33176-1029
Mailing Address11400 N Kendall Dr Ste 204Miami, FL 33176-1029 · (305) 279-2222 · Fax (305) 501-2031
Phone(305) 279-2222
Fax(305) 501-2031
Organization SubpartNo
Authorized OfficialJuan Alberto MantillaPresident · (305) 279-4222
Enumeration DateJanuary 7, 2010
Last NPPES UpdateJune 29, 2021
NPPES CertifiedJune 29, 2021
✔ NPI 1962732388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME77038
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
11400 N KENDALL DR STE 204, Miami, FL 33176
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Other Identifiers 1

Medicaid266223000FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Juan A Mantilla Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Juan A Mantilla MD PA, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Juan Mantilla, MD
Internal Medicine
NPI 1699715292
11400 N KENDALL DR STE 204
Miami, FL 33176
(305) 279-2222
✔ PECOS✔ Accepts MedicareSame address
Humberto Jimenez, M.D.
Family Practice
NPI 1417278227
9101 SW 24TH ST STE 100
Miami, FL 33165
(305) 260-7506
✔ PECOS✔ Accepts Medicare4.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1008941

Juan A Mantilla MD · Miami, FL
Active · expires Feb 2, 2027
CLIA Number10D1008941
Laboratory TypePhysician Office
Certificate Effective DateFebruary 3, 2025
Certificate Expiration DateFebruary 2, 2027
Laboratory DirectorJuan A. Mantilla
Laboratory Phone(305) 279-4222
Laboratory LocationJuan A Mantilla MD11400 N Kendall Dr Ste 204, Miami, FL 33176
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Juan A Mantilla MD PA's NPI number?

The NPI number for Juan A Mantilla MD PA is 1962732388. It was assigned to this organization in the NPPES registry on January 7, 2010.

Where is Juan A Mantilla MD PA located?

Juan A Mantilla MD PA is located at 11400 N Kendall Dr Ste 204, Miami, FL 33176. The listed phone number is (305) 279-2222.

What is Juan A Mantilla MD PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Juan A Mantilla MD PA enrolled in Medicare?

Yes. Juan A Mantilla MD PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Juan A Mantilla MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Juan A Mantilla MD PA, in Family Practice and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Juan A Mantilla MD PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1008941) is associated with this NPI, valid through February 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Juan A Mantilla MD PA was last updated on June 29, 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.