Provider Demographics
NPI:1750014601
Name:OLIVERA QUINTANA, OSCAR (MD)
Entity type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:
Last Name:OLIVERA QUINTANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 PATRICIA ALFORD DR
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-6758
Mailing Address - Country:US
Mailing Address - Phone:939-276-7996
Mailing Address - Fax:
Practice Address - Street 1:353 CYPRESS PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3326
Practice Address - Country:US
Practice Address - Phone:844-665-4827
Practice Address - Fax:888-806-0191
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23407208D00000X
FLACN1553208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice