Provider Demographics
NPI:1275796898
Name:QUINTERO, MARIA DE LOS ANGELES (DC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DE LOS ANGELES
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 NW 82ND AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6682
Mailing Address - Country:US
Mailing Address - Phone:305-406-9636
Mailing Address - Fax:305-406-1602
Practice Address - Street 1:3650 NW 82ND AVE STE 304
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6682
Practice Address - Country:US
Practice Address - Phone:305-406-9636
Practice Address - Fax:305-406-1602
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7448111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU00926Medicare UPIN