Provider Demographics
NPI:1659309185
Name:QUINTERO, ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name: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:RA12 VIA DEL RIO
Mailing Address - Street 2:RIO CRISTAL
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6021
Mailing Address - Country:US
Mailing Address - Phone:787-755-2222
Mailing Address - Fax:787-755-2222
Practice Address - Street 1:A4 CALLE ANICETO DIAZ
Practice Address - Street 2:GOLDEN HILL
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-2620
Practice Address - Country:US
Practice Address - Phone:787-755-2222
Practice Address - Fax:787-755-2222
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11739208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2744-1OtherPROSAM
PR7770009OtherHUMANA DE PR
PR060114OtherCRUZ AZUL DE PR
PR3111739OtherUIA
PR5130OtherFIRST MEDICAL
PR88551OtherSSS
PR88551OtherSSS
PR7770009OtherHUMANA DE PR