Provider Demographics
NPI:1629379458
Name:QUINTERO, YAQUELIN L (NP-C)
Entity Type:Individual
Prefix:MS
First Name:YAQUELIN
Middle Name:L
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6722 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-2962
Mailing Address - Country:US
Mailing Address - Phone:813-654-2544
Mailing Address - Fax:813-653-4391
Practice Address - Street 1:14521 UNIVERSITY POINT PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-5424
Practice Address - Country:US
Practice Address - Phone:813-977-3600
Practice Address - Fax:813-977-1664
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF0910402363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner