Provider Demographics
NPI:1518690346
Name:ARRIETA QUINTERO, ESDRAS ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:ESDRAS
Middle Name:ANTONIO
Last Name:ARRIETA QUINTERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 BRICKELL BAY DR APT 404
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2912
Mailing Address - Country:US
Mailing Address - Phone:786-439-7179
Mailing Address - Fax:
Practice Address - Street 1:900 NW 17TH ST FL 4
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1134
Practice Address - Country:US
Practice Address - Phone:305-326-6391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL34857207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34857OtherTRN LICENCE