Provider Demographics
NPI:1477526796
Name:QUINTERO, BRAULIO (MD FACR)
Entity Type:Individual
Prefix:DR
First Name:BRAULIO
Middle Name:
Last Name:QUINTERO
Suffix:
Gender:M
Credentials:MD FACR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3698 MARINA STATION
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681
Mailing Address - Country:US
Mailing Address - Phone:787-834-7735
Mailing Address - Fax:787-805-5375
Practice Address - Street 1:CALLE DEL RIO #15
Practice Address - Street 2:ESQ MEDITACION
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-7735
Practice Address - Fax:787-805-5375
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5022207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C79472Medicare UPIN
25591Medicare ID - Type Unspecified