Provider Demographics
NPI:1255311858
Name:QUINTELA, PABLO ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:PABLO
Middle Name:ALEJANDRO
Last Name:QUINTELA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11011 SHERIDAN STREET
Mailing Address - Street 2:SUITE 302
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33026-1532
Mailing Address - Country:US
Mailing Address - Phone:954-437-1500
Mailing Address - Fax:954-437-0136
Practice Address - Street 1:11011 SHERIDAN STREET
Practice Address - Street 2:SUITE 302
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33026-1532
Practice Address - Country:US
Practice Address - Phone:954-437-1500
Practice Address - Fax:954-437-0136
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME-0064557207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23867Medicare ID - Type Unspecified
FLF75289Medicare UPIN