Provider Demographics
NPI:1538284393
Name:OFICINA MEDICA DR QUINTERO PSC
Entity Type:Organization
Organization Name:OFICINA MEDICA DR QUINTERO PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:QUINTERO SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-844-6669
Mailing Address - Street 1:PMB 194
Mailing Address - Street 2:1575 AVENIDA MUNOZ RIVERA URB MARIANI
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-844-7027
Mailing Address - Fax:787-844-6888
Practice Address - Street 1:450 CALLE FERROCARRIL
Practice Address - Street 2:SUITE 302 SANTA MARIA MEDICAL BLDG
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-4107
Practice Address - Country:US
Practice Address - Phone:787-844-6669
Practice Address - Fax:787-844-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10601174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR84966Medicare PIN