Provider Demographics
NPI:1225006307
Name:OTERO-QUINTANA, JORGE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:A
Last Name:OTERO-QUINTANA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:ESTANCIAS DE TORTUGUERO
Mailing Address - Street 2:629 TURIN ST.
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-854-0800
Mailing Address - Fax:787-854-0808
Practice Address - Street 1:EDIFICIO MEDICO I DR. PEDRO BLANCO LUGO
Practice Address - Street 2:CARR. 2 KM. 47.7 SUITE 305
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4665
Practice Address - Country:US
Practice Address - Phone:787-854-0800
Practice Address - Fax:787-854-0808
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR10724207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6606086111OtherMCS
PR6740082OtherHUMANA
PR89144OtherTRIPLE S
PR061503OtherLCA
PR6740082OtherHUMANA
PRH27303Medicare UPIN