Provider Demographics
NPI:1770972168
Name:LEON QUINTANA, DELVIS (BS)
Entity type:Individual
Prefix:
First Name:DELVIS
Middle Name:
Last Name:LEON QUINTANA
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11401 SW 40TH ST STE 211
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3338
Mailing Address - Country:US
Mailing Address - Phone:305-603-7063
Mailing Address - Fax:305-603-8705
Practice Address - Street 1:11401 SW 40TH ST STE 211
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165
Practice Address - Country:US
Practice Address - Phone:305-603-7063
Practice Address - Fax:305-603-8705
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker