Provider Demographics
NPI:1326484502
Name:QUINTERO, GEORGE JESUS
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:JESUS
Last Name:QUINTERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6660 SW 130TH AVE
Mailing Address - Street 2:1704
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5215
Mailing Address - Country:US
Mailing Address - Phone:305-322-1229
Mailing Address - Fax:
Practice Address - Street 1:6660 SW 130TH AVE
Practice Address - Street 2:1704
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-5215
Practice Address - Country:US
Practice Address - Phone:305-322-1229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst