Provider Demographics
NPI:1790094175
Name:QUINTANA, JOEL ALFREDO (LMT)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:ALFREDO
Last Name:QUINTANA
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8002 SW 149TH AVE
Mailing Address - Street 2:B216
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3144
Mailing Address - Country:US
Mailing Address - Phone:305-979-6178
Mailing Address - Fax:305-441-2883
Practice Address - Street 1:8002 SW 149TH AVE
Practice Address - Street 2:B216
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3144
Practice Address - Country:US
Practice Address - Phone:305-979-6178
Practice Address - Fax:305-441-2883
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2016-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLMA45867225700000X
FL698778920246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy