Provider Demographics
NPI:1841208097
Name:QUINTANA, GIRALDO M (OD)
Entity Type:Individual
Prefix:
First Name:GIRALDO
Middle Name:M
Last Name:QUINTANA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 S DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6126
Mailing Address - Country:US
Mailing Address - Phone:305-448-8686
Mailing Address - Fax:305-357-1701
Practice Address - Street 1:2550 S DOUGLAS RD
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6126
Practice Address - Country:US
Practice Address - Phone:305-448-8686
Practice Address - Fax:305-357-1701
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3663152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist