Provider Demographics
NPI:1871643445
Name:QUINTANA, RICHARD
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:QUINTANA
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:QUINTANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HEALTH SERVICES TECH
Mailing Address - Street 1:100 MACARTHUR CSWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-5101
Mailing Address - Country:US
Mailing Address - Phone:305-353-4350
Mailing Address - Fax:
Practice Address - Street 1:100 MACARTHUR CSWY
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-5101
Practice Address - Country:US
Practice Address - Phone:305-353-4350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider