Provider Demographics
NPI:1184658759
Name:QUESADA- PINTOR, ANGEL MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:MANUEL
Last Name:QUESADA- PINTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8924 RIVER BLF
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2385
Mailing Address - Country:US
Mailing Address - Phone:210-464-7161
Mailing Address - Fax:
Practice Address - Street 1:1530 CELEBRATION BLVD STE 407
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5165
Practice Address - Country:US
Practice Address - Phone:321-939-4137
Practice Address - Fax:321-939-4109
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME131184207Q00000X
PR13,130207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLKR367OtherMEDICARE