Provider Demographics
NPI:1508277658
Name:QUINTANA, ZORAIDA
Entity Type:Individual
Prefix:
First Name:ZORAIDA
Middle Name:
Last Name:QUINTANA
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 1:313 W HUBBARD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1345
Mailing Address - Country:US
Mailing Address - Phone:614-599-2466
Mailing Address - Fax:
Practice Address - Street 1:5555 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4048
Practice Address - Country:US
Practice Address - Phone:614-823-7833
Practice Address - Fax:614-823-7865
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031193021835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy