Provider Demographics
NPI:1710073648
Name:QUINTERO, LUIS C (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:C
Last Name:QUINTERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:420 S DIXIE HWY
Mailing Address - Street 2:SUITE 4E
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2222
Mailing Address - Country:US
Mailing Address - Phone:305-666-9963
Mailing Address - Fax:305-666-3768
Practice Address - Street 1:420 S DIXIE HWY
Practice Address - Street 2:SUITE 4E
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2222
Practice Address - Country:US
Practice Address - Phone:305-666-9963
Practice Address - Fax:305-666-3768
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0048270174400000X, 207RE0101X
FL0048270207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL046763400Medicaid
FL04122Medicare ID - Type Unspecified
FL046763400Medicaid