Provider Demographics
NPI:1467591982
Name:QUIROGA-MONTELEON, ADRIANA M (DC)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:M
Last Name:QUIROGA-MONTELEON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ADRIANA
Other - Middle Name:M
Other - Last Name:QUIROGA-MONTELEON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:282 FLANDERS DR
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-4042
Mailing Address - Country:US
Mailing Address - Phone:321-409-0209
Mailing Address - Fax:321-409-0208
Practice Address - Street 1:5560 BABCOCK ST NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2300
Practice Address - Country:US
Practice Address - Phone:321-409-0209
Practice Address - Fax:321-409-0208
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8748111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381827600Medicaid
FL381827600Medicaid