| Doctor Name: | CONSTANTINE A. MANTZ |
| NPI Number: | 1396743290 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | ME0080838 |
| Business Practice Address: | 1419 Se 8th Ter Cape Coral, FL - 339903213 |
| Business Phone Number: | 2397723202 |
| Business Fax Number: | 2397738346 |
| Mailing Address: | 2234 Colonial Blvd, FORT MYERS |
| State: | FL |
| Postal Code: | 339071412 |
| Phone Number: | 2399317342 |
| Fax Number: | 2399317385 |
| NPI Enumeration Date: | 07/13/2005 |
| NPI Last Update Date: | 08/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | ME0080838 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |