Provider Demographics
NPI:1023580891
Name:QUINTANA, LINA M (PA C)
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:M
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:PA C
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Mailing Address - Street 1:2160 COLONIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1410
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:8991 BRIGHTON LN
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-7505
Practice Address - Country:US
Practice Address - Phone:239-949-3130
Practice Address - Fax:239-949-8580
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2019-08-27
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Provider Licenses
StateLicense IDTaxonomies
FLPA9111724363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant