Provider Demographics
NPI:1174638720
Name:QUINTANILLA, DAYSI MARLENE (RNNP)
Entity Type:Individual
Prefix:
First Name:DAYSI
Middle Name:MARLENE
Last Name:QUINTANILLA
Suffix:
Gender:F
Credentials:RNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11602 NW 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6621
Mailing Address - Country:US
Mailing Address - Phone:305-620-4929
Mailing Address - Fax:305-620-4954
Practice Address - Street 1:5190 NW 167TH ST
Practice Address - Street 2:STE 109
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33014-6328
Practice Address - Country:US
Practice Address - Phone:305-620-4929
Practice Address - Fax:305-620-4954
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2950782163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3791AMedicare ID - Type Unspecified
FLQ28542Medicare UPIN