Provider Demographics
NPI:1629064456
Name:QUINTERO, MARICARMEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARICARMEN
Middle Name:
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARICARMEN
Other - Middle Name:QUINTERO
Other - Last Name:FORS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6056 BOYNTON BEACH BLVD STE 145
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3500
Mailing Address - Country:US
Mailing Address - Phone:561-439-1800
Mailing Address - Fax:561-439-4874
Practice Address - Street 1:6056 BOYNTON BEACH BLVD STE 145
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3500
Practice Address - Country:US
Practice Address - Phone:561-439-1800
Practice Address - Fax:561-439-4874
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93561207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17259ZOtherMEDICARE
FLI39890Medicare UPIN
FLI39890Medicare UPIN