Provider Demographics
NPI:1386220416
Name:QUINTERO MARTINEZ, MIRIELA
Entity Type:Individual
Prefix:
First Name:MIRIELA
Middle Name:
Last Name:QUINTERO MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9030 SW 125TH AVE APT 301E
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7163
Mailing Address - Country:US
Mailing Address - Phone:786-442-9296
Mailing Address - Fax:
Practice Address - Street 1:6303 BIRD RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4825
Practice Address - Country:US
Practice Address - Phone:786-216-7382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management