Provider Demographics
NPI:1457907735
Name:QUINTERO, PAULA CLEOPATRA
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:CLEOPATRA
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15009 COMMONWEALTH AVE N
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33868-5612
Mailing Address - Country:US
Mailing Address - Phone:863-327-9519
Mailing Address - Fax:
Practice Address - Street 1:15009 COMMONWEALTH AVE N
Practice Address - Street 2:
Practice Address - City:POLK CITY
Practice Address - State:FL
Practice Address - Zip Code:33868-5612
Practice Address - Country:US
Practice Address - Phone:863-327-9519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist