Provider Demographics
NPI:1477295970
Name:QUINTANA, CASIMIRO III
Entity Type:Individual
Prefix:MR
First Name:CASIMIRO
Middle Name:
Last Name:QUINTANA
Suffix:III
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 1:16232 E RICE PL APT A
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-7005
Mailing Address - Country:US
Mailing Address - Phone:720-301-6444
Mailing Address - Fax:
Practice Address - Street 1:16232 E RICE PL APT A
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-7005
Practice Address - Country:US
Practice Address - Phone:720-301-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider