Provider Demographics
NPI:1619967072
Name:QUINTERO PAZ, GREIDA MARLENE (MD)
Entity Type:Individual
Prefix:MRS
First Name:GREIDA
Middle Name:MARLENE
Last Name:QUINTERO PAZ
Suffix:
Gender:F
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:A28 CALLE MAIN
Mailing Address - Street 2:URBANIZACION FLAMINGO HILLS
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-2339
Mailing Address - Country:US
Mailing Address - Phone:787-787-4706
Mailing Address - Fax:787-787-4706
Practice Address - Street 1:CALLE 6 ESQUINA 13 BLOQUE H-1 OFICINA #3 SANTA MONICA
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-785-5454
Practice Address - Fax:787-785-5454
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11733208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
0087612Medicare ID - Type Unspecified
G42901Medicare UPIN